title: Brainstem conundrum: the Chiari I malformation.
abstract: OBJECTIVE
  To describe the Chairi I Malformation in relation to the anatomy of the brain and spinal cord, the common manifestations of the condition, diagnostic considerations, and management for the primary care provider.
  
  
  METHODS
  Extensive review of the world-wide scientific literature on the condition, supplemented with actual case studies.
  
  
  CONCLUSIONS
  The adult Chairi I Malformation is an insidious congenital brainstem anomaly that consists of caudal displacement of the cerebellar tonsils, brainstem and fourth ventricle into the upper cervical space, resulting in overcrowding of the posterior fossa.
  
  
  CONCLUSIONS
  Due to the vague, and often ambiguous presenting symptoms of Chiari I Malformation, many patients are misdiagnosed with conditions such as multiple sclerosis, fibromyalgia, chronic fatigue syndrome, or psychiatric disorders. Patients frequently experience symptoms months to years prior to accurate diagnosis and often incur irreversible neurologic deficits.
authors.affiliation: Division of Neurosurgery, University of Missouri Hospital and Clinics, USA. muellerdm@health.missouri.edu
authors.forename: D
authors.initials: D
authors.lastname: Mueller
mesh_terms: D000328:Adult; D001933:Brain Stem / Q000002:abnormalities* / Q000473:pathology; D003291:Conversion Disorder / Q000188:drug therapy / Q000628:therapy; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006261:Headache / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013116:Spinal Cord / Q000002:abnormalities* / Q000473:pathology; D013315:Stress, Psychological