Sagittal T1 MRI without contrast of the brain (left) shows a small posterior fossa with downward cerebellar tonsil herniation and a small fourth ventricle. There is kinking of the spinal cord at the cervico-medullary junction. Sagittal (above right) and axial (below right) T2 MRI without contrast of the spine shows a low-lying conus medullaris with the spinal cord nerve roots terminating in a posteriorly located cerebrospinal fluid filled sac which is not covered by skin at the level of the L5-S1 vertebral bodies.
Pediatric Imaging 