Case 209

Medical history

12-year-old female patient, previously healthy and with adequate vaccination, presented to her pediatrician with a story of progressive headache and neck pain in the last 2 months. There was loss of strength in the upper limb associated with nausea, vomits, lack of appetite and weight loss of 10 kg in the last month. Upon examination, there was neck stiffness, paralysis of the right arm, paresis of the left arm and need of support for ambulation.

Based on the clinical picture and the images, which one of the following is the most likely diagnosis?

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