title: Pediatric Chiari I malformations: do clinical and radiologic features correlate?
abstract: BACKGROUND
  Although Chiari I malformation is increasingly recognized in children, little is known about its clinical presentation in this age group.
  
  
  OBJECTIVE
  To evaluate the relationship between clinical and MRI features of pediatric Chiari I malformations.
  
  
  METHODS
  We performed a chart review and MRI analysis of 49 children with Chiari I malformation. The degree of tonsillar ectopia was compared with age at onset, presence of syringomyelia, and a neurologic severity score as follows: asymptomatic = 0, symptomatic with normal neurologic examination = 1, and symptomatic with abnormal examination = 2.
  
  
  RESULTS
  Age at onset of symptoms ranged from 10 months to 14 years. Fifty-seven percent of patients were asymptomatic. Headache and neck pain were the most frequent complaints. Syringomyelia was detected in 14% of patients and skull base abnormalities in 50%. The magnitude of tonsillar ectopia (5 to 23 mm) correlated with severity score (p = 0.04) but not with other clinical measures.
  
  
  CONCLUSIONS
  The clinical symptoms of Chiari I malformations in children are nearly identical to those seen in adults. Children with greater amounts of tonsillar ectopia on MRI are more likely to be symptomatic.
authors.affiliation: Department of Neurology, University of California at San Francisco, 94143-0114, USA.
authors.forename: Y W
authors.initials: YW
authors.lastname: Wu
authors.forename: C T
authors.initials: CT
authors.lastname: Chin
authors.forename: K M
authors.initials: KM
authors.lastname: Chan
authors.forename: A J
authors.initials: AJ
authors.lastname: Barkovich
authors.forename: D M
authors.initials: DM
authors.lastname: Ferriero
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001139:Arnold-Chiari Malformation / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male