Chiari I malformations: Clinical and radiologic reappraisal

A. D. Elster, M. Y.M. Chen

Research output: Contribution to journalArticlepeer-review

347 Scopus citations

Abstract

Clinical findings and magnetic resonance (MR) images in 68 patients with Chiari I malformations were retrospectively analyzed to identify those radiologic features that correlated best with clinical symptoms. A statistically significant (P = .03) female predominance of the malformation was observed, with a female: male ratio of approximately 3:2. Associated skeletal anomalies were seen in 24% of patients. Syringomyelia was detected in 40% of patients, most commonly between the C-4 and C-6 levels. Of the 25 patients who presented with spinal symptoms, 23 (92%) proved to have a syrinx at MR imaging. When the syrinx extended into the medulla (n = 3), however, brain stem symptoms predominated. Patients with objective brain stem or cerebellar signs had the largest mean tonsillar herniations. Patients with tonsillar herniations greater than 12 mm were invariably symptomatic, but approximately 30% of patients with tonsils herniating 5-10 mm below the foramen magnum were asymptomatic at MR imaging. 'Incidental' Chiari I malformations are thus much more common than previously recognized, and careful clinical assessment remains the cornerstone for proper diagnosis and management.

Original languageEnglish
Pages (from-to)347-353
Number of pages7
JournalRadiology
Volume183
Issue number2
DOIs
StatePublished - Jan 1 1992

Keywords

  • Brain, MR
  • Brain, abnormalities
  • Spine, MR
  • Spine, abnormalities
  • Syringomyelia

Fingerprint

Dive into the research topics of 'Chiari I malformations: Clinical and radiologic reappraisal'. Together they form a unique fingerprint.

Cite this