Tonsillar herniation. Not being a radiologist I cannot determine whether the relatively dark areas over the frontal cortex represent mass effect; if not this would be Arnold-Chiari malformation.
Arnold Chiari disease type one or type two, depending on whether or not lumbar myelomeningocele presence of tonsillar herniation on CT
Correct answer: Yes, it's an Arnold-Chiari malformation. It consists of a downward displacement of the cerebellar tonsils through the foramen magnum, sometimes causing hydrocephalus as a result of obstruction of cerebrospinal fluid outflow.