Chiari type I malformation in children

Indication for preoperative MRI of neural axis abnormalities in patients with presumed thoracolumbar/lumbar idiopathic scoliosis

“…The diagnosis of a Chiari 1 malformation was made when the herniation of the tonsils was below the foramen magnum by 5 mm or more [17].…”

Arnold-Chiari malformation type I and sleep-disordered breathing: An uncommon manifestation of an important pediatric problem

“…In the 11 children with Chiari malformation type I studied by Dure et al (1989), seven had normal neurologic findings on physical examination. Three patients had apnea as a presenting complaint.…”

“…Although this patient showed almost immediate improvement in his respiratory status, it is not unusual for some children to not demonstrate improvement in their central apnea immediately following decompression surgery. In some cases it may take 6 months to 1 year before improvement is seen (Dure et al, 1989;Shiihara et al, 1995). Botelho et al (2000) demonstrated that patients with craniocervical disorders have a higher probability of sleep disturbances and should have multichannel pneumogram sleep studies performed.…”

“…Instructions include observing the incision site for any signs of drainage, redness, or tense fluid collection and observing the patient for severe headache, fever greater then 101.5°F, increased severe stiff neck, or lethargy. A follow-up MRI is usually done at 3 months (Dure et al, 1989;Nagib, 1994;Strayer, 2001). …”

“…However, with the increased use of magnetic resonance imaging (MRI), this craniocervical malformation is being identified earlier and often in asymptomatic patients before the onset of neurologic symptoms such as headache, neck pain, ataxia, sensory deficit, lower cranial nerve palsies, and nystagmus. Occulomotor disturbances, syncope, torticollis, paralysis, scoliosis, sleep apnea, and sudden death resulting from Arnold-Chiari type I malformation also have been reported (Ali, Russell, Awada, & McLean, 1996;Dure, Percy, Cheek, & Laurent, 1989;Strayer, 2001). …”