Understanding brain MRI findings

I had a brain MRI because of pressure or "numbing pain" in forehead with slight vertigo.  I get relief when i lay down.  This is persistent for 2 years now.  There are 2 findings and I don't understand them.  
1.  5 mm of cerebellar tonsillar ectopia, of uncertain clinical significance.
Is this considered a type 1 Chiari malformation?  We are currently ignoring this because my problem is in the forehead.
2.  Slight increased horizontal orientation of the clivus with mild increased soft tissue posterior to the dens likely congenital and degenerative in nature, respectively.  No aggressive features.  This results in mild increased angulation of the cervical medullary (and then it cuts off).
What is that?  No idea what that even means.  Does anyone know?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Chiari malformation is an abnormal extension of the cerebellar tonsils (a structure in the posterior brain) through a hole in the skull called the foramen magnum. It is often asymptomatic or may present with headache, cranial nerve problems, sleep apnea, or hearing/vestibular problems. One associated feature with chiari’s is its association with syringomyelia, which is dilatation of the central canal in the spinal cord. The cause of the low lying cerebellum could be genetics/development or it could be trauma induced. (More than likely it is a type I malformation). Given the soft tissue at the clivus, you may need to have further workup for connective tissue disorders such as Marfans or Ehlers Danlos to name a few.

Have you followed up with your physician since receiving the MRI report? I suggest that you discuss your questions with him/her. You may need to be referred to a neurologist for headache management.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.