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Chiari I malformation
  1. Helen Williams
  1. Correspondence to Dr Helen Williams, Radiology Department, Birmingham Children's Hospital, Birmingham B4 6NH, UK; helen.williams{at}

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A 6-year-old boy was investigated for persistent headaches, frequently accompanied by photophobia and vomiting. He had been sent home from school several times over the past 4 months, and had recently been admitted to hospital with an exacerbation of the headaches. On that occasion meningitis was excluded. There were no abnormal neurological signs on examination. An MR scan was arranged as an outpatient which showed a Chiari I malformation. Look at the midline T1-weighted image from his cranial MR scan (figure 1), and answer the following questions. Read on to confirm the answers and learn more about this condition.

Figure 1


  1. The cerebellar tonsils are herniated below the foramen magnum. True or false?

  2. Cerebrospinal fluid (CSF) spaces at the craniocervical junction are normal in size. True or false?

  3. The posterior fossa is relatively small. True or false?

  4. The cerebellar vermis is small. True or false?

  5. Chiari I malformation is typically an …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.