Asymptomatic Chiari Type I malformation: should patients be advised against participation in contact sports?

Abstract

Overall, the authors feel that there should be no restriction of sports participation for CM-I patients, but a discussion to make them and their families aware of the possible increased risks is important.

Patient advice regarding participation in sport in children with disorders of cerebrospinal fluid (CSF) circulation: a national survey of British paediatric neurosurgeons

“…Three papers addressing sports participation in patients with Chiari malformations were identified [ 6 – 8 ]. One literature review examined the consequences of trauma or contact sports on patients with asymptomatic Chiari type I malformations [ 6 ]. Other than anecdotal evidence of sudden death in patients following head or neck injury, severe neurological deterioration was not identified in any studies of larger cohorts.…”

The Knee Jerk Reaction

“…It is often associated with a cervical syrinx in approximately 20% to 40% of cases. 1 The prevalence of Chiari I malformation is estimated at 0.01% to 3.6% and is sometimes associated with other congenital craniocervical anomalies including craniosynostosis, hyperostosis, atlantoaxial assimilation, and Klippel-Feil syndrome. 2 Patients with Chiari malformation often remain asymptomatic and the diagnosis is increasingly being made incidentally with MRI for other indications.…”

Natural History and Conservative Treatment Options in Chiari Malformation Type I in Adults: A Literature Update

“…Some patients with asymptomatic CM-I develop symptoms after undergoing trauma, and there are reports on deaths occurring during sports [31][32][33]. Neck and left shoulder pain accompanied by paresthesia in the upper limbs was described in the case reported by Sung et al [22].…”

“…CM-I has also been a controversial topic in asymptomatic patients who practice sporting activities [31][32][33].…”

“…There was not enough evidence to differentiate these outcomes between adults and children. The authors recommend that there be no restrictions associated with the participation of asymptomatic patients with CM-I and without syringomyelia in contact sports but that the subject must be well discussed with the patients and their families [32].…”