Pediatric Chiari I malformations: do clinical and radiologic features correlate?
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.
Wu
Y W
YW
Department of Neurology, University of California at San Francisco, 94143-0114, USA.
Chin
C T
CT
Chan
K M
KM
Barkovich
A J
AJ
Ferriero
D M
DM
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