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34 year old man with headache, vertigo, clumsiness, and unsteady vision
Digital Journal of Ophthalmology 1996
Volume 2, Number 1
August 14, 1996
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Melanie Ryan-Graham, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Simmons Lessell, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Ancillary Testing
Radiographic Studies
The prolonged and gradually progressive nature of the presented patient's symptoms, in the absence of risk factors for other entities in the differential, led to the suspicion of an anatomical process.
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Figure 1
On CT scan, a bony abnormality of the clivus was evident.

Figure 2
Figures 2-3. On MRI scan, the bony excrescence of the clivus was quite dramatic, with impingement of the medulla which rests its ventral surface on the clivus. The medulla was displaced 5 cm posteriorly, and the cerebellar tonsils were displaced posteriorly INTO the upper cervical spinal canal.

Figure 3