Spinal cord and brain stem anomalies are being diagnosed with increasing frequency, as more magnetic resonance imaging (MRI) scans are being obtained in athletes. These conditions can be a source of significant concern for both athletes and the physicians involved in their care. This concern is magnified by the consequences associated with spinal cord injury and the dearth of information surrounding the proper management of many of these conditions. This chapter reviews the literature relevant to athletic activity with regard to congenital and vascular conditions affecting the spinal cord, with particular attention to Chiari malformations, syringomyelia, tethered cord, spinal cysts, and arterial anomalies and injuries. Each section offers an overview of the condition, recommendations for evaluation, and expected impact on athlete participation, with “common sense” approaches on how to manage these conditions in an athlete.
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Chern JJ, Gordon AJ, Mortazavi MM, Tubbs RS, Oakes WJ, et al. Pediatric Chiari malformation Type 0: a 12-year institutional experience. J Neurosurg Pediatr. 2011;8:1–5.PubMedCrossRefGoogle Scholar
Proctor MR, Scott RM, Oakes WJ, Muraszko KM, et al. Chiari malformation. Neurosurg Focus. 2011;31:Introduction.Google Scholar
Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS, et al. Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging. J Neurosurg. 2000;92:920–6.PubMedCrossRefGoogle Scholar
Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJ, Maher CO, et al. Chiari malformation Type I and syrinx in children undergoing magnetic resonance imaging. J Neurosurg Pediatr. 2011;8:205–13.PubMedCrossRefGoogle Scholar
Wan MJ, Nomura H, Tator CH, et al. Conversion to symptomatic Chiari I malformation after minor head or neck trauma. Neurosurgery. 2008;63:748–53; discussion 53.Google Scholar
Wolf DA, Veasey SP 3rd, Wilson SK, Adame J, Korndorffer WE, et al. Death following minor head trauma in two adult individuals with the Chiari I deformity. J Forensic Sci. 1998;43:1241–3.PubMedGoogle Scholar
Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJ, Maher CO, et al. Natural history of Chiari malformation Type I following decision for conservative treatment. J Neurosurg Pediatr. 2011;8:214–21.PubMedCrossRefGoogle Scholar
Rocque BG, George TM, Kestle J, Iskandar BJ, et al. Treatment practices for Chiari malformation Type I with syringomyelia: results of a survey of the American Society of Pediatric Neurosurgeons. J Neurosurg Pediatr. 2011;8:430–7.PubMedCrossRefGoogle Scholar
Schijman E, Steinbok P. International survey on the management of Chiari I malformation and syringomyelia. Childs Nerv Syst. 2004;20:341–8.PubMedCrossRefGoogle Scholar
Heiss JD, Patronas N, DeVroom HL, et al. Elucidating the pathophysiology of syringomyelia. J Neurosurg. 1999;91:553–62.PubMedCrossRefGoogle Scholar
Magge SN, Smyth MD, Governale LS, et al. Idiopathic syrinx in the pediatric population: a combined center experience. J Neurosurg Pediatr. 2011;7:30–6.PubMedCrossRefGoogle Scholar
Hoffman HJ. The tethered spinal cord. In: Holtzman RNN, Stein BM, editors. The tethered spinal cord. New York: Theime-Stratton; 1985. pp. 91–8.Google Scholar
Kim AH, Kasliwal MK, McNeish B, Silvera VM, Proctor MR, Smith ER, et al. Features of the lumbar spine on magnetic resonance images following sectioning of filum terminale. J Neurosurg Pediatr. 2011;8:384–9.PubMedCrossRefGoogle Scholar
Thiex R, Mulliken JB, Revencu N, et al. A novel association between RASA1 mutations and spinal arteriovenous anomalies. Am J Neuroradiol. 2010;31:775–9.PubMedCrossRefGoogle Scholar