Syringomyelia is often linked to pathological lesions of the foramen magnum. Note in this case who was on treatment for TBM and suddenly developed cervical cord symptoms. Spinomedullary junction shows altered contour, with posteriorly displaced spinal cord. Cisterna magna is obliterated and prominent anterior CSF space. Thick leptomeningeal enhancement is seen in the prepontine and retrocerebellar cisterns. Note is also made of syringobulbia & syringomyelia. Diagnosis of chronic arachnoiditis at foramen magnum was made. There is some tonsillar descent as well, which may indicate co-existent chiari malformation. Further reading-- Syringomyelia due to chronic arachnoiditis at the foramen magnum. Journal of the Neurological Sciences. Volume 8, Issue 3, May-June 1969, Pages 451-464
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