|
A 6 year-old girl presented with neck pain, difficulty walking and numbness over the neck and upper shoulders. |
| Chiari Malformation Type I and Syrinx: (Left) T2-weighted
sagittal MRI of the spine; (Right)
T1-weighted sagittal MRI of the brain. Note the Chiari
malformation type I associated with the cervical syrinx, wherein the brainstem and cerebellar tonsils descend
below the foramen magnum. In this case, the cerebellum and caudal brainstem
descended 25 mm below the foramen magnum. Note the syrinx in the high cervical cord.
If one looks closely, one can see that the syrinx is septated. The syrinx was the
likely cause
of the patient's numbness over her neck and upper shoulders
(suspended sensory level). This malformation is know as a Chiari malformation, type I. There are several types of Chiari malformations. In Type I, the malformation is limited to descent of the cerebellar tonsils and medulla into the spinal canal. This malformation is often asymptomatic. Some cases are associated with syringomyelia and/or syringobulbia. When symptomatic, patients typically develop posterior headaches and dizziness. In more severe cases, patients may develop vertical nystagmus and other cranial nerve abnormalities. |
Revised
11/27/06
Copyrighted 2006. David C Preston