case_images: PMC3707328_01
case_images: Her left upper limb holding in a peculiar position, with the wrist in extension and the elbow joint in flexion
case_images: SNI-4-79-g001.jpg
case_images: PMC3707328_01_SNI-4-79-g001.jpg
case_images: F1
case_images: On admission, her physical examination revealed spastic paresis of left upper limb, with the limb assuming a peculiar posture at rest, with the wrist in extension and the elbow joint in flexion [Figure 1].
case_images: (a) Preoperative sagittal T1-weighted MRI revealing the cerebellar tonsillar herniation of 8 mm. (b) Axial T1-weighted MRI 6 months before the onset and (c) one week after the onset, and (d) sagittal T2-weighted MRI 6 months before the onset and (e) one week after the onset manifesting no progression of cerebellar tonsillar herniation and no syringomyelia
case_images: SNI-4-79-g002.jpg
case_images: PMC3707328_01_SNI-4-79-g002.jpg
case_images: F2
case_images: No recurrence of hydrocephalus was demonstrated [Figure 2a-e]. There was no evidence of syringomyelia or abnormal T2 signal in the spinal cord [Figure 2d and e].
case_images: (a) Sagittal fast imaging employing steadystate acquisition (FIESTA) MRI 6 months before the onset and (b) one week after the onset of monoparesis revealed different shapes of tonsils. (c) Axial FIESTA MRI one week after the onset showed the right-sided dominant tonsillar herniation
case_images: SNI-4-79-g003.jpg
case_images: PMC3707328_01_SNI-4-79-g003.jpg
case_images: F3
case_images: Sagittal fast imaging employing steady state acquisition (FIESTA) MRI clearly showed that compared with the previous in detail, the tonsil changed into beaked shape and was asymmetry [Figure 3].
case_images: Postoperative sagittal T2-weighted MRI one week after FMD showing the improvement of the cerebellar tonsillar herniation
case_images: SNI-4-79-g004.jpg
case_images: PMC3707328_01_SNI-4-79-g004.jpg
case_images: F4
case_images: Postoperative MRI demonstrated an ascent of the cerebellar tonsil of 4 mm compared with before FMD [Figure 4].