Brainstem conundrum: the Chiari I malformation.
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.
Mueller
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Division of Neurosurgery, University of Missouri Hospital and Clinics, USA. muellerdm@health.missouri.edu
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