Management of incidental findings on MRI brain scans*
| Condition | Needs regular clinical review | Needs regular imaging | Needs referral to neurosurgeon |
|---|---|---|---|
| Chiari 1 malformation without syrinx | Yes—annual follow for 2 years after diagnosis and thereafter if any Chiari-related symptoms | No—only if symptomatic | Yes |
| Chiari 1 malformation with syrinx | Yes—annual follow-up | Repeat imaging at 6 months, 1 year followed by imaging on clinical grounds | Yes |
| Arachnoid cysts | Yes—annual follow-up until schooling at 5 years and thereafter if any symptoms of raised intracranial pressure | Repeat imaging at 1 year, then repeat if symptomatic | Yes |
| Pineal cysts | Yes—annual follow-up until school age (4–5 years of age) | Repeat imaging at 6 months, 1 year followed by imaging on clinical grounds | Yes |
| Intracranial lipomas | No | No | No |
| Filum terminale lipomas | Yes | No—only if symptomatic | Yes |
| Dural venous anomalies | No | No | Yes—single consultation to rule out any associated vascular anomalies, ie, aneurysm, cavernoma, arteriovenous malformation |
*Each case may have to be tailored to the patient's clinical situation, social and cultural factors.