Chiari 2 Malformation with Myelomeningocele and Tethered Cord

Findings:

Sagittal T2 weighted imaging of the cervical and lumbar spine demonstrates a small posterior fossa with significant inferior extent of cerebellar tonsillar tissue and the medulla through an enlarged foramen magnum. The fourth ventricle is markedly elongated and effaced. An elongated conus is noted with tethered cord posteriorly and a posterior element defect near the lumbosacral junction. No definite protrusion of meninges beyond the spinal canal is seen. There is superimposed cervical degenerative disc disease.

Discussion/Differential Diagnosis:

This case illustrates the invariable association of myelomeningocele with CNS Chiari II findings. Additional discussion of Chiari II:

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