 24 YEAR OLD WITH HEADACHE |
| Contributed by:
Grant Lattin, Resident, David Grant Medical Center, Travis AFB, California, USA. |
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Patient: 24 year old female |
| History: 24 year old female with headache |
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| Findings: CT and MR demonstrates the cerebellar tonsils descending > 5mm below the level of the foramen magnum. |
| Diagnosis: Chiari I malformation |
| Discussion: The primary finding in a Chiari I malformation is cerebellar tonsil herniation below the level of the foramen magnum. These patients will often present in the 2nd or 3rd decade of life with symptoms such as headache, clumsiness, paresthesias, and muscles weakness, to name a few. Typically, greater than 5 mm of descent below the level of the episthion and basion is significant. The tonsils sometimes reach the level of C3, obliterating the cisterna magna. There is an association with cervical syringohydromelia (not present in this case). The fourth ventricle is normal in location without evidence of hydrocephalus. Additional associations include Klippel-Feil syndrome, anomalies of C1 or the odontoid process, reduced supraocciput height, and a short clivus. Surgical suboccipital decompression has been used in cases with clinically significant symptoms |
| References: 1. Grossman RI, Yousem DM. The Requisites: Neuroradiology, 2nd ed., Mosby, Philadelphia, 2003, p. 436-437. 2. Poe LB, Coleman LL, Mahmud F. Congenital central Nervous system anomalies. Radiographics. 1989 Sep;9(5):801-26. |
| Comments: No comments posted. |
| Additional Details:
Case Number: 8542749 The reader is fully responsible for confirming the accuracy of this content. |
