Dynamic Cerebellar Tonsils in Chiari Malformation

A 5-year-old asymptomatic boy had apparent optic nerve head elevation on routine ophthalmology examination. Magnetic resonance (MR) imaging of the brain revealed a previously undiagnosed Chiari I malformation with crowding of the foramen magnum and low-lying cerebellar tonsils (Figure, A). Cine phase sagittal MR imaging (Video; available at www.jpeds.com) showed altered cerebrospinal fluid egress through the foramen magnum. It also demonstrated dynamic motion of the cerebellar tonsils that correlated with the cardiac cycle.

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