Malformations of the craniocervical junction (chiari type I and syringomyelia: classification, diagnosis and treatment)

Fernández, Alfredo Avellaneda; Guerrero, Alberto Isla; Martínez, Maravillas Izquierdo; Vázquez, María Eugenia Amado; Fernández, Javier Barrón; Octavio, Ester Chesa i; Labrado, Javier de la Cruz; Silva, Mercedes Escribano; Araoz, Marta de Gamboa Fernández de Fernández; García-Ramos, R.; Ribes, Miguel García; Gómez, Carmen; Valdivia, Joaquín Insausti; Valbuena, Ramón Navarro; Ramón., José

doi:10.1186/1471-2474-10-s1-s1

Cited by 139 publications

(62 citation statements)

References 40 publications

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“…The diagnostic imaging modality of choice is MRI. [13] An encephalocele is a congenital hernia of intracranial contents which protrude from a cranial defect. The intracranial contents which extrude to the exterior from the defect may include cerebrospinal fluid (CSF), meningeal structures, or brain tissue [14,15] our patient had a meningocele instead.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Chiari Malformation Type 4

Nemayire¹,

Kabulo²,

Zimani³

et al. 2017

SJCM

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Abstract:The Chiari malformations are a family of conditions characterized by developmental or, less commonly, acquired displacements of the cerebellum. The original 19th century description by Hans Chiari delineated 4 types, but only types 1 and 2 are more than just curiosities. In his initial description, Chiari classified the hindbrain malformations into type I, II and III and then latter added type IV malformation. Type IV is a very rare type. It is characterized by cerebellar hypoplasia or aplasia and tentorial hypoplasia. There is no hindbrain herniation in this type. We report a case of a 6 year old male patient who presented to us with a 6 year history of an occipitocervical mass and inability to stand and walk for one year and a 5 month history of headache and vomiting. CT scan of the brain showed a midline posterior fossa bone defect with a meningocele with active obstructive hydrocephalus and hypoplastic cerebellum without hindbrain herniation. A diagnosis of a posterior fossa congenital anomaly (Chiari 4) with obstructive hydrocephalus and occipito-cervical meningocele was made. Ventriculo-peritoneal shunt was inserted three days post admission. Patient was then electively taken to theatre five months later for repair of the occipitocervical meningocele.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Chiari Malformation Type 4

Nemayire¹,

Kabulo²,

Zimani³

et al. 2017

SJCM

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“…These individuals still have symptoms associated with a Chiari malformation, most likely due to abnormalities in the flow of CSF within the skull and spinal canal. [7222324]…”

Section: Discussionmentioning

confidence: 99%

Not all cases of nyctalopia are benign: Unusual and serendipitous presentation of Arnold–Chiari Type 1 malformation at a Pediatric Tertiary Care Center

Patra

Kirtane

2016

J Pediatr Neurosci

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The Arnold–Chiari Type 1 malformation (CM1) is a rare congenital abnormality characterized by ectopia or caudal herniation of the cerebellar tonsils through the foramen magnum into the cervical spine, resulting in crowding at the craniocervical junction. It seldom presents in childhood with symptoms and a normal neurological examination. More typically, CM1 presents in young adult women with neurological symptoms including a headache, cervical pain, cranial nerve palsies, neurosensory deficit, and ataxia. Ocular manifestations associated with Chiari I include third and sixth cranial nerve paresis and convergence/divergence abnormalities. Papilledema is a rare manifestation of Chiari I with a clinical presentation often similar to that of idiopathic intracranial hypertension. To underscore this noteworthy complication, the authors report a case of an 8-year-old boy who presented with nyctalopia and suboccipital headaches, but was diagnosed serendipitously as a case of papilledema due to Chiari I malformation.

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“…11 It is not clear how many of these patients would be diagnosed with ACM type 1 if a cervical MRI was performed on them. The majority of sources refer to surgical procedures as the main treatment for ACM type 1.…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms appear as the patient ages; it is more frequent in females than males with a 3:1 ratio, with an age range of 6 to 60 and a peak diagnosis age of 40 years. 1,11 A diagnosis of ACM type 1 is often suspected following physical examination and history. Patients often complain of headaches in the posterior-occipital area, radiating to the eyes with a pressure-type pain made worse with coughing, sneezing, or yelling.…”

Section: Wwwjournalchiromedcommentioning

confidence: 99%

Chiropractic Care for Headaches and Dizziness of a 34-Year-Old Woman Previously Diagnosed With Arnold-Chiari Malformation Type 1

Sergent

Cofano

2014

Journal of Chiropractic Medicine

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Objective: The purpose of this case study is to describe the chiropractic care of a patient with headaches and dizziness. Clinical Features: A 34-year-old woman with a history of headaches, dizziness, photophobia, and temporary loss of vision aggravated by postural positions while bending forward sought conservative care for her symptoms. She reported a prior diagnosis of Arnold-Chiari malformation (ACM) type 1 by magnetic resonance imaging in 2005 that revealed descending cerebellar tonsils measured at 5 mm with an impression of ACM type 1. A new magnetic resonance image taken in 2013 indicated the cerebellar tonsils measured at 3 mm and did not project through the plane of the foramen magnum. The diagnosis of ACM type 1 was no longer applicable; however, the signs and symptoms of ACM type 1 persisted. Intervention and Outcome: She was treated using cervical chiropractic manipulation using diversified technique. The dizziness and headache were resolved after 3 visits. At her 3-month follow-up, she continued to be symptom-free. Conclusion: A patient with headaches and dizziness and a previous diagnosis of ACM type 1 responded positively to chiropractic care.

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Malformations of the craniocervical junction (chiari type I and syringomyelia: classification, diagnosis and treatment)

Cited by 139 publications

References 40 publications

A Rare Case of Chiari Malformation Type 4

A Rare Case of Chiari Malformation Type 4

Not all cases of nyctalopia are benign: Unusual and serendipitous presentation of Arnold–Chiari Type 1 malformation at a Pediatric Tertiary Care Center

Chiropractic Care for Headaches and Dizziness of a 34-Year-Old Woman Previously Diagnosed With Arnold-Chiari Malformation Type 1

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