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Headache in children with Chiari I malformation

Irene Toldo1, Marta Tangari, Rodica Mardari

  • 1Juvenile Headache Centre, Department of Woman and Child Health, University of Padua, Padua, Italy.

Headache
|April 29, 2014
PubMed

Insights

Headache is the most common symptom in children with Chiari 1 malformation. Headache attributed to Chiari 1 malformation was the most frequent pattern observed in this pediatric group.

Area of Science:

  • Neurology
  • Pediatrics
  • Neurosurgery

Background:

  • Chiari 1 malformation involves cerebellar tonsil herniation through the foramen magnum.
  • Headache is a primary symptom, but its pattern in pediatric cases is not well-defined.
  • Understanding headache characteristics is crucial for diagnosis and management in children.

Purpose of the Study:

  • To investigate the frequency and characteristics of headaches in children diagnosed with Chiari 1 malformation.
  • To analyze headache patterns at initial evaluation and during follow-up.
  • To explore associations between headache patterns, clinical signs, and the extent of tonsillar ectopia.

Main Methods:

  • Retrospective chart review of 45 pediatric patients (<18 years) with tonsillar ectopia.
  • Neuroimaging data analyzed between 2002 and 2010.
  • Semistructured interviews and headache classification using the International Classification of Headache Disorders (ICHD-2).

Main Results:

  • Headache was reported by 73% of pediatric Chiari 1 malformation patients.
  • Headache attributed to Chiari 1 malformation was identified in 27% of these patients.
  • Associations found between clinical presentation, headache patterns, and the degree of tonsillar ectopia (borderline, mild, severe).

Conclusions:

  • Headache is the predominant symptom in pediatric Chiari 1 malformation.
  • Headache attributed to Chiari 1 malformation represents the most common headache pattern in this population.
  • The presence of headache attributed to Chiari 1 malformation plus three other signs/symptoms strongly predicts severe tonsillar ectopia.
Abstract

Keywords:
Chiari 1 malformationICHD-IIcerebellar tonsils herniationchildrenheadache

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