Case Notes
History
40 yo male with prior traumatic brain hematoma 2 year earlier. Now has increasing severe headache, imbalance and blurred vision.Exam
MR flair
Prior Study
T1-w spin-echo axial and coronal T2-w MR1. Chronic post traumatic brain injury with mild global atrophy and ex vacuo grade 1.4/4 ventriculomegaly limited to the lateral ventricles.
2. There is evidence of early downward central incisural herniation, and advanced downward cerebellar tonsillar herniation.
Sagittal post contrast MR
1. CNS findings of intracranial hypotension; correlate with measured CSF pressure for confirmation with both unexplained downward incisural and tonsillar herniation.
2. Ex vacuo grade 1.4/4 lateral ventriculomegaly.