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 Vol. 9 No. 2, February 2003
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Right arrow Neurological Surgery

AAP Grand Rounds 9:18-19 (2003)
© 2003 American Academy of Pediatrics

NEUROSURGERY

The Chiari Malformation, Type 1, in Early Childhood

Source: Greenlee JDW, Donovan KA, Hasan DM, et al. Chiari I malformation in the very young child: the spectrum of presentations and experience in 31 children under age 6 years. Pediatrics. 2002;110:1212–1219.[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.

The Chiari malformation type 1 (CM1) is defined as abnormal protrusion of the tonsils of the cerebellum through the foramen magnum down into the cervical spinal canal. The quantitative threshold for diagnosis of CM1 is somewhat arbitrary, but the most widely accepted definition is descent of the tonsils >5 mm below the plane of the foramen.1 The developmental lesion responsible for CM1 is believed, in most instances, to be insufficient growth of the osseous boundaries of the posterior cranial fossa: there is simply not enough room within the posterior fossa to accommodate the neural structures that belong there.2,3 Symptoms and neurological signs may develop either on the basis of mechanical compression of the brainstem at the foramen magnum or on the basis of disturbance of cerebrospinal fluid (CSF) dynamics, leading to syringomyelia.3,4 The potential clinical manifestations of CM1 are legion.

In the current era of widely . . . [Full Text of this Article]

Joseph H. Piatt, Jr, MD, FAAP
Neurological Surgery and Pediatrics, Drexel University College of Medicine, St. Christopher’s Hospital for Children, Philadelphia, PA