Case 351 Medical history A 51-year-old female patient initiated paresthesia of the inferior members one year ago. The patient developed worsening of symptoms, presenting with paresis of the inferior members, gait difficulties, progressive dysphagia for solids and liquids, dysarthria and dysphonia. CT scan of the brain was performed (image 1). Based on its findings, magnetic resonance imaging (MRI) of the cervical spine was requested (images 2 and 3). Image 1: Contrast enhanced computed tomography of the brain, axial view, at the medulla oblongata levelImage 2: Magnetic resonance imaging (MRI) of cervical spine, weighed in T2, sagittal section.Image 3: Magnetic resonance imaging (MRI) of cervical spine, weighed in T2, axial section, at level of C7. Question:Considering the clinical history and radiological findings, what is the most likely diagnosis? Multiple sclerosis Meningioma Arnold-Chiari malformation Intramedullary tumor Time is Up! Time's up
