Headache and Chiari I Malformation in Children and Adolescents

Victorio, M. Cristina; Khoury, Chaouki K.

doi:10.1016/j.spen.2016.01.001

Cited by 16 publications

(7 citation statements)

References 38 publications

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“…In patients in whom there is high suspicion for Chiari I deformity, a noncontrast MRI scan of the brain to include a sagittal T2-weighted sequence of the craniocervical junction with optional phase-contrast CSF flow study at the craniocervical junction is the study of choice. The Chiari I deformity is a condition characterized by the herniation of the cerebellar tonsils through the foramen magnum with headache as its most common symptom in older children [35,36]. In children <3 years of age, abnormal oropharyngeal function is commonly demonstrated.…”

Section: Discussion Of Procedures By Variant Variant 1: Child Primarmentioning

confidence: 99%

ACR Appropriateness Criteria ® Headache–Child

Hayes

Palasis

Bartel

et al. 2018

Journal of the American College of Radiology

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Headaches in children are not uncommon and have various causes. Proper neuroimaging of these children is very specific to the headache type. Care must be taken to choose and perform the most appropriate initial imaging examination in order to maximize the ability to properly determine the cause with minimum risk to the child. This evidence-based report discusses the different headache types in children and provides appropriate guidelines for imaging these children. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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Section: Discussion Of Procedures By Variant Variant 1: Child Primarmentioning

confidence: 99%

ACR Appropriateness Criteria ® Headache–Child

Hayes

Palasis

Bartel

et al. 2018

Journal of the American College of Radiology

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“…Even though the condition is unusual, both a clinical and imaging differential diagnosis should be established since patients with ACM may report symptoms in the dental arches as well as the TMJ and irradiation towards the oropharynx and the ears and adjacent nerves (10,27,28), which does not exactly indicate the presence of TMD.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of ACM-I is a challenge and is usually made by a neurosurgeon. Orofacial pain may not correlate with the maxillofacial image findings in patients with ACM-I (27,28). The diagnosis is usually made with the aid of magnetic resonance of the cerebellum.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of ACM consists of improving the region of the foramen magnum in the craniovertebral junction in an attempt to reduce the painful symptoms by reducing the nerve compression caused by cerebellar herniation (8). Although there are no unanimous criteria about surgical intervention, with a rate ranging from 9 to 75%, Victorio and Khoury (28) have stated that there is a consensus about considering the possibility of surgical intervention for ACM when the clinical and imaging signs and symptoms are clearly correlated. The surgical diagnosis is variable (8).…”

Section: Discussionmentioning

confidence: 99%

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Orofacial clinical features in arnold chiari type i malformation: a case series

Figueiredo

Neres

Vasconcelos

et al. 2019

International Journal of Oral and Maxillofacial Surgery

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Background: Arnold Chiari malformation (ACM) is characterized by an anatomical defect at the base of the skull where the cerebellum and the spinal cord herniate through the foramen magnum into the cervical spinal canal. Among the subtypes of the condition, ACM type I (ACM-I) is particularly outstanding because of the severity of symptoms. This study aimed to analyze the orofacial clinical manifestations of patients with ACM-I, and discuss their demographic distribution and clinical features in light of the literature. Material and Methods: A case series with patients with ACM-I treated between 2012 and 2015 was described. The sample consisted of patients who were referred by the Department of Neurosurgery to the Oral and Maxillofacial Surgery Service of Hospital da Restauração in Brazil for the assessment of facial symptomatology. A questionnaire was applied to evaluate the presence of painful orofacial findings. Data are reported using descriptive statistical methods. Results: Mean patient age was 39.3 years and the sample consisted mostly of male patients. A high prevalence of headache (50%) and pain in the neck (66.7%) and masticatory muscles (50%) was found. Only one patient reported difficulty in performing mandibular movements and two reported jaw clicking sounds. Mean mouth opening was 40.83 mm. Conclusions: ACM-I patients may exhibit orofacial symptoms which may mimic temporomandibular joint disorders. This study brings interesting information that could help clinicians and oral and maxillofacial surgeons to understand this uncommon condition and also help with the diagnosis of patients with similar physical characteristics by referring them to a neurosurgeon.

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“…On this basis, patients with this disorder at times may be underdiagnosed, underscoring the importance of awareness of this malformation on the part of clinicians, general dentists and oral and maxillofacial surgeons. Even though the condition is unusual, both a clinical and imaging differential diagnosis should be established since patients with ACM may report symptoms in the dental arches as well as the TMJ and irradiation towards the oropharynx and the ears and adjacent nerves ( 10 , 27 , 28 ), which does not exactly indicate the presence of TMD.…”

Section: Discussionmentioning

confidence: 99%

Orofacial clinical features in Arnold Chiari type I malformation: A case series

et al. 2018

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BackgroundArnold Chiari malformation (ACM) is characterized by an anatomical defect at the base of the skull where the cerebellum and the spinal cord herniate through the foramen magnum into the cervical spinal canal. Among the subtypes of the condition, ACM type I (ACM-I) is particularly outstanding because of the severity of symptoms. This study aimed to analyze the orofacial clinical manifestations of patients with ACM-I, and discuss their demographic distribution and clinical features in light of the literature.Material and MethodsA case series with patients with ACM-I treated between 2012 and 2015 was described. The sample consisted of patients who were referred by the Department of Neurosurgery to the Oral and Maxillofacial Surgery Service of Hospital da Restauração in Brazil for the assessment of facial symptomatology. A questionnaire was applied to evaluate the presence of painful orofacial findings. Data are reported using descriptive statistical methods.ResultsMean patient age was 39.3 years and the sample consisted mostly of male patients. A high prevalence of headache (50%) and pain in the neck (66.7%) and masticatory muscles (50%) was found. Only one patient reported difficulty in performing mandibular movements and two reported jaw clicking sounds. Mean mouth opening was 40.83 mm.ConclusionsACM-I patients may exhibit orofacial symptoms which may mimic temporomandibular joint disorders. This study brings interesting information that could help clinicians and oral and maxillofacial surgeons to understand this uncommon condition and also help with the diagnosis of patients with similar physical characteristics by referring them to a neurosurgeon. Key words:Arnold-Chiari malformation, facial pain, diagnosis, orofacial.

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Headache and Chiari I Malformation in Children and Adolescents

Cited by 16 publications

References 38 publications

ACR Appropriateness Criteria ® Headache–Child

ACR Appropriateness Criteria ® Headache–Child

Orofacial clinical features in arnold chiari type i malformation: a case series

Orofacial clinical features in Arnold Chiari type I malformation: A case series

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