Chiari I malformation and spinal cord injury: cause for concern in contact athletes?

We present a case of transient quadriparesis in an 8-yr-old football player with a normal cervical spinal canal but Chiari I malformation of the hindbrain. Chiari I consists of herniation of the cerebellar tonsils through the foramen magnum, which reduces space available for the spinal cord. Magnetic resonance imaging (MRI) of the brain or cervical spine can identify asymptomatic Chiari I, whereas previously myelography was necessary. The incidence and natural history of Chiari I malformation is reviewed, with special reference to the question of return-to-play in young athletes.