[Clinical patterns of Arnold-Chiari malformations]

The purpose of the study was clinical analysis of the patients with Arnold-Chiari malformation and the definition of the groups according to the clinical presentation. The authors present the series of 210 patients treated between 1980 and 1997 in the Department of Neurosurgery. These patients were classified into 4 groups: syringomyelia, cerebellar syndrome, cerebello-spinal syndrome and hydrocephalus. Syringomyelia was the commonest clinical presentation in the series. Less often cerebellar and cerebello-spinal syndromes were observed. Non-communicating hydrocephalus was rare. The symptomatology of the Arnold-Chiari malformation appears extremely variable, but most often is related to the associated cavitation of the spinal cord. The signs and symptoms in patients presenting cerebellar syndrome may lead to misdiagnosis of insufficiency of the vertebrobasilar circulation. Diffuse involvement of the motor and sensory system with cerebello-spinal syndrome may cause the patient to be diagnosed incorrectly as having sclerosis multiplex. The MR is the method of choice in the diagnosis of Arnold-Chiari malformation.