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Chiari type I malformation in a pediatric population

Leslie A Aitken1, Camilla E Lindan, Stephen Sidney

  • 1Department of Pediatrics, University of California San Francisco, San Francisco, CA 94117-0137, USA.

Pediatric Neurology
|May 13, 2009
PubMed

Insights

Chiari I malformation in children is often found incidentally. Older age at diagnosis increases the risk of symptoms like headaches and neck pain.

Area of Science:

  • Neurology
  • Pediatrics
  • Radiology

Background:

  • The natural history of Chiari I malformation in pediatric populations is not well understood.
  • Chiari I malformation is a condition where brain tissue extends into the spinal canal.

Purpose of the Study:

  • To investigate the natural history of Chiari I malformation in children.
  • To identify clinical and radiographic predictors of significant neurologic symptoms in pediatric Chiari I patients.

Main Methods:

  • Population-based retrospective cohort study.
  • Reviewed radiology reports of head and spine MRI scans for children under 20 (1997-1998).
  • Analyzed medical records and imaging for 51 identified pediatric Chiari I cases.

Main Results:

  • Chiari I malformation was identified in 1% of pediatric MRI scans.
  • Headache (55%) and neck pain (12%) were the most frequent symptoms.
  • Older age at diagnosis correlated with higher odds of headache and significant neurologic symptoms.

Conclusions:

  • Chiari I malformation is an underrecognized cause of headaches in children.
  • The condition is often incidentally discovered in asymptomatic children.
  • Further research is needed to establish prognosis and optimal treatment for pediatric Chiari I.

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