New Ventriculographic Aspects of the Arnold-Chiari Malformation

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Abstract
Previously undescribed pneumo-encephalographic aspects of the neuroanatomical complex which bears the name Arnold-Chiari malformation were documented radiologically and were confirmed pathologically. The following entities constitute this unique appearance the frequent presence of an abnormal configuration of the anterior portion of the 3rd ventricle, sometimes appearing to represent a coronal transventricular connexus inferior to the anterior commissure and at other times presenting as an anterior pseudodiver-ticulum through the lamina terminalis; a massa intermedia which may be unduly large and more anteriorly located than usual; and absence of the septum pellucidum anteriorly with resultant fusion of the lateral ventricles; sharply pointed inferior margins of the lateral ventricles at the foramen of Monro. These findings, when considered as a complex, may be as pathognomonic of the Arnold-Chiari malformation as the demonstration of the caudal herniation of the brain stem and cerebellum through the foramen magnum. This is of particular importance in cases of myelomeningocele with hydrocephalus in which the 4th ventricle cannot be demonstrated at ventriculography because of an associated aqueduct stenosis.

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