Türk Nöroşirürji Dergisi 2015 , Vol 25 , Num 2
Clinical Presentation of Chiari Type 1 Malformation
İstanbul Tıp Fakültesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye Chiari Type I Malformation (CM1) is still one of the most discussed topics in neurosurgical practice with its definition, natural course, treatment indications and methods as well as with the associated anomalies and diseases. As a general opinion, the diagnosis is made if the cerebellar tonsils protrude at least 5 mm below the foramen magnum level.

The clinical findings and symptoms are associated with the volume loss of the posterior fossa along with the compressed and dysfunctioning structures as a result of the impending tonsils. The findings can be classified in five main groups as suboccipital headache, ocular disturbance, auditory disturbance, clinical symptoms related to the brain stem, and spinal disturbances. Pediatric CM1 patients differ from adults especially with other congenital musculoskeletal anomalies, scoliosis concomitant to syringomyelia and the existence of nasopharyngeal control disturbances.

Other discussion points about CM1 are patients without any symptoms and incidentally diagnosed patients. Approximately 80% of pediatric neurosurgeons report that incidentally diagnosed pediatric patients that have no symptoms, generally do not become symptomatic during their follow-up. Neurosurgeons have chosen to monitor these patients instead of operating on them until the emergence of neurological findings.

The best approach for the patients without any symptoms is thought to be periodic neurological examinations and MR imaging to check possible syringomyelia formation. Anahtar Kelimeler : Chiari, Tonsillar herniation, Syringomyelia