This is a cute case. I look for this on every single MRI of the brain I read, particularly if the patient is presenting with headaches. I always look for a Chiari I malformation, eyeball shape (could they need glasses), and sinus disease. Of course I’m going to rule out brain tumors and bleeding, but Chiari I malformation, misshaped eyeballs, and sinus infections need to be excluded with chronic headaches.
Check the featured image. It is a different patient with Chiari I that shows a syrinx in the upper cervical spine. If you are interested, I will show that case which has the typical decompression surgery and accompanying imaging.