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Hindbrain hernia headache and syncope in type I Arnold-Chiari malformation
V Palma1, L Sinisi, V Andreone
1Servizio di Neurofisiopatologia, Ospedale Nuovo Pellegrini, Napoli.
Acta Neurologica
|December 1, 1993
Summary
Two women experienced fainting and headaches triggered by exertion due to Arnold-Chiari malformation. This condition involves brainstem compression and pressure differences, potentially causing these symptoms.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Arnold-Chiari malformation is a structural defect in the cerebellum.
- Cough headaches and syncope are neurological symptoms that warrant investigation.
Observation:
- Two young female patients presented with recurrent syncopal episodes.
- Occipital headaches were exacerbated by Valsalva maneuvers like coughing and sneezing, as well as physical exertion and postural changes.
Findings:
- Magnetic Resonance Imaging (MRI) confirmed Type I Arnold-Chiari malformation in both patients.
- A craniospinal pressure dissociation was identified, suggesting potential brainstem compression.
Implications:
- Arnold-Chiari malformation may be a significant factor in the pathogenesis of exertional headaches and syncope.
- Understanding pressure dynamics is crucial for diagnosing and managing these neurological symptoms.