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Chiari I malformation in children with transverse myelitis
Sathya Vadivelu1, Sudhakar Vadivelu2,3, Maureen Mealy4
1a Department of Pediatric Rehabilitation Medicine , Johns Hopkins University and the Kennedy Krieger Institute , Baltimore , MD , USA.
Insights
Transverse myelitis (TM) is linked to a higher prevalence of asymptomatic Chiari I malformation (CMI) in children. Further research is needed to understand CMI
Area of Science:
- Pediatric Neurology
- Neuroinflammation
- Spinal Cord Disorders
Background:
- Transverse myelitis (TM) is an acute inflammatory spinal cord injury.
- Management of asymptomatic Chiari I malformation (CMI), especially with a spinal syrinx, is controversial.
- Understanding CMI in pediatric TM is crucial.
Purpose of the Study:
- To determine the occurrence of CMI in pediatric TM patients.
- To evaluate management outcomes for CMI in this population.
Main Methods:
- Retrospective cohort study of 61 pediatric TM cases.
- Reviewed demographic data, radiographic findings, symptoms, and outcomes.
- An 8-year study period.
Main Results:
- Eight cases (1 in 10) of CMI were identified in the TM cohort.
- CMI onset occurred by 16 months of age, affecting the cervical spinal cord.
- CMI developed years after TM onset in some cases.
Conclusions:
- A high prevalence of CMI exists in pediatric TM patients.
- Further prospective studies are required.
- Investigating CMI natural history and recovery in neuroinflammatory disorders is essential.
Purpose:
Transverse myelitis (TM) is an acute inflammatory spinal cord injury. Asymptomatic Chiari I malformation (CMI) management is highly controversial, particularly when associated with a spinal syrinx. Here, we assess the occurrence of CMI in the pediatric TM population and management outcomes.
Methods:
We performed a retrospective cohort study based on 61 consecutively identified pediatric TM cases over an -8-year period. We reviewed demographic characteristics, radiographic findings, presenting symptoms, and long-term outcomes.
Results:
Eight CMI cases were identified within the TM cohort; all presented with TM by 16 months of age and affecting the cervical spinal cord. In three cases, CMI developed 15 months to 6 years after the onset of TM. One in 10 children with TM had CMI.
Conclusion:
These findings demonstrate a high prevalence of CMI in patients with TM. Large prospective clinical studies are needed to further investigate the natural history and recovery strategies of CMI involved with neuroinflammatory disorders.
