Clinical Notes on Chiari Malformation

Chiari malformations (CMs) are variant structural setup of cerebellum and brain stem at the craniovertebral junction. Normally the cerebellum and parts of the brain stem lie above the foramen magnum. When the part of the cerebellum and/or brainstem protrudes into the upper spinal canal through foramen magnum, it is defined as CM. Chiari malformations may develop when part of the skull is smaller than normal or misshapen, due to which the cerebellum herniates into spinal canal through foramen magnum. This compresses the cerebellum and brainstem affecting functions controlled by these parts and blocks the flow of cerebrospinal fluid that surrounds and cushions the brain and spinal cord. Chiari malformation may cause sensory loss, ataxia, weakness, nystagmus, spastic limbs to name a few. Thus, various morbid and mortal neurologic disorders result from CM. Therefore, sound and thorough knowledge of CM and its variant anatomy are essential for diagnosis and management of neurologic disorders. Therefore, review study has been carried out for updating and consolidating the knowledge of all the variations of CMs. Literature search was carried out using databases, SciELO, ScopeMed, MEDLINE, PubMed, and Wiley Online Library. Papers containing original data were selected and secondary references retrieved from bibliographies. Various terms related to CMs were used for net surfing. The knowledge will be of immense importance to neurologists and neurosurgeons to diagnose and treat the CMs and decrease the mortality associated with CM and to radiologists for correctly interpreting the magnetic resonance imaging. Address correspondence and reprint requests to Dr Rajani Singh, Additional Professor, Department of Anatomy, AIIMS Rishikesh, Veerbhadramarg, 249203 Uttrakhand, India; E-mail: nani_sahayal@rediffmail.com Received 12 December, 2017 Accepted 7 January, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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