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Natural History of Chiari Malformations

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The Chiari Malformations

Abstract

Although many aspects of Chiari malformation type I (CM I) natural history remain unsolved, some progress is being made. Recently, several groups have reported on CM I natural history in selected groups of patients that were managed without surgery. Each of these studies followed patients for several years. In general, the natural history for this subgroup of Chiari patients is benign, although cases of clinical progression as well as spontaneous improvement were seen. The available data clarify the natural history of CM I for the subgroup of CM I patients that are considered to be asymptomatic or minimally symptomatic and without neurological deficits. Spinal syringes in patients with CM I follow a varied and unpredictable natural course.

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References

  1. Haines SJ, Berger M. Current treatment of Chiari malformations types I and II: a survey of the Pediatric Section of the American Association of Neurological Surgeons. Neurosurgery. 1991;28(3):353–7.

    Article  CAS  PubMed  Google Scholar 

  2. Haroun RI, Guarnieri M, Meadow JJ, Kraut M, Carson BS. Current opinions for the treatment of syringomyelia and chiari malformations: survey of the Pediatric Section of the American Association of Neurological Surgeons. Pediatr Neurosurg. 2000;33(6):311–7.

    Article  CAS  PubMed  Google Scholar 

  3. Schijman E, Steinbok P. International survey on the management of Chiari I malformation and syringomyelia. Childs Nerv Syst. 2004;20(5):341–8.

    Article  PubMed  Google Scholar 

  4. Avellino AM, Britz GW, McDowell JR, Shaw DW, Ellenbogen RG, Roberts TS. Spontaneous resolution of a cervicothoracic syrinx in a child. Case report and review of the literature. Pediatr Neurosurg. 1999;30(1):43–6.

    Article  CAS  PubMed  Google Scholar 

  5. Klekamp J, Iaconetta G, Samii M. Spontaneous resolution of Chiari I malformation and syringomyelia: case report and review of the literature. Neurosurgery. 2001;48(3):664–7.

    Article  CAS  PubMed  Google Scholar 

  6. Kyoshima K, Bogdanov EI. Spontaneous resolution of syringomyelia: report of two cases and review of the literature. Neurosurgery. 2003;53(3):762–9.

    Article  PubMed  Google Scholar 

  7. Olivero WC, Dinh DH. Chiari I malformation with traumatic syringomyelia and spontaneous resolution: case report and literature review. Neurosurgery. 1992;30(5):758–60.

    CAS  PubMed  Google Scholar 

  8. Sun JC, Steinbok P, Cochrane DD. Spontaneous resolution and recurrence of a Chiari I malformation and associated syringomyelia. Case report. J Neurosurg. 2000;92(2 Suppl):207–10.

    CAS  PubMed  Google Scholar 

  9. Sun PP, Harrop J, Sutton LN, Younkin D. Complete spontaneous resolution of childhood Chiari I malformation and associated syringomyelia. Pediatrics. 2001;107(1):182–4.

    Article  CAS  PubMed  Google Scholar 

  10. Tokunaga M, Minami S, Isobe K, Moriya H, Kitahara H, Nakata Y. Natural history of scoliosis in children with syringomyelia. J Bone Joint Surg Br. 2001;83(3):371–6.

    Article  CAS  PubMed  Google Scholar 

  11. Waldau B, Domeshek LF, Leigh FA, Lum KC, Fuchs HE, Marcus JR, et al. Spontaneous resolution of a 13-mm Chiari malformation type I in relation to differential growth of the posterior fossa volume. J Neurosurg Pediatr. 2009;3(2):110–4.

    Article  PubMed  Google Scholar 

  12. Elliott R, Kalhorn S, Pacione D, Weiner H, Wisoff J, Harter D. Shunt malfunction causing acute neurological deterioration in 2 patients with previously asymptomatic Chiari malformation type I. Report of two cases. J Neurosurg Pediatr. 2009;4(2):170–5.

    Article  PubMed  Google Scholar 

  13. Hopkins TE, Haines SJ. Rapid development of Chiari I malformation in an infant with Seckel syndrome and craniosynostosis. Case report and review of the literature. J Neurosurg. 2003;98(5):1113–5.

    Article  PubMed  Google Scholar 

  14. Lipson AC, Ellenbogen RG, Avellino AM. Radiographic formation and progression of cervical syringomyelia in a child with untreated Chiari I malformation. Pediatr Neurosurg. 2008;44(3):221–3.

    Article  PubMed  Google Scholar 

  15. Massimi L, Caldarelli M, Frassanito P, Di Rocco C. Natural history of Chiari type I malformation in children. Neurol Sci. 2011;32(Suppl 3):275–7.

    Article  Google Scholar 

  16. Aboulezz AO, Sartor K, Geyer CA, Gado MH. Position of cerebellar tonsils in the normal population and in patients with Chiari malformation: a quantitative approach with MR imaging. J Comput Assist Tomogr. 1985;9(6):1033–6.

    Article  CAS  PubMed  Google Scholar 

  17. Barkovich AJ, Wippold FJ, Sherman JL, Citrin CM. Significance of cerebellar tonsillar position on MR. AJNR Am J Neuroradiol. 1986;7(5):795–9.

    CAS  PubMed  Google Scholar 

  18. Rekate HL. Natural history of the Chiari type I anomaly. J Neurosurg Pediatr. 2008;2(3):177–8.

    Article  PubMed  Google Scholar 

  19. Vernooij MW, Ikram MA, Tanghe HL, Vincent AJ, Hofman A, Krestin GP, et al. Incidental findings on brain MRI in the general population. N Engl J Med. 2007;357(18):1821–8.

    Article  CAS  PubMed  Google Scholar 

  20. Aitken LA, Lindan CE, Sidney S, Gupta N, Barkovich AJ, Sorel M, et al. Chiari type I malformation in a pediatric population. Pediatr Neurol. 2009;40(6):449–54.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Elster AD, Chen MY. Chiari I malformations: clinical and radiologic reappraisal. Radiology. 1992;183(2):347–53.

    Article  CAS  PubMed  Google Scholar 

  22. Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS. Asymptomatic Chiari type I malformations identified on magnetic resonance imaging. J Neurosurg. 2000;92(6):920–6.

    Article  CAS  PubMed  Google Scholar 

  23. Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJ, Maher CO. Chiari malformation type I and syrinx in children undergoing magnetic resonance imaging. J Neurosurg Pediatr. 2011;8(2):205–13.

    Article  PubMed  Google Scholar 

  24. Wu YW, Chin CT, Chan KM, Barkovich AJ, Ferriero DM. Pediatric Chiari I malformations: do clinical and radiologic features correlate? Neurology. 1999;53(6):1271–6.

    Article  CAS  PubMed  Google Scholar 

  25. Katzman GL, Dagher AP, Patronas NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA. 1999;282(1):36–9.

    Article  CAS  PubMed  Google Scholar 

  26. Weber F, Knopf H. Cranial MRI as a screening tool: findings in 1,772 military pilot applicants. Aviat Space Environ Med. 2004;75(2):158–61.

    PubMed  Google Scholar 

  27. Yue NC, Longstreth WT Jr, Elster AD, Jungreis CA, O’Leary DH, Poirier VC. Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the Cardiovascular Health Study. Radiology. 1997;202(1):41–6.

    Article  CAS  PubMed  Google Scholar 

  28. Morris Z, Whiteley WN, Longstreth WT Jr, Weber F, Lee YC, Tsushima Y, et al. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2009;339:b3016.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Mikulis DJ, Diaz O, Egglin TK, Sanchez R. Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology. 1992;183(3):725–8.

    Article  CAS  PubMed  Google Scholar 

  30. Luciano MG. Chiari malformation: are children little adults? Neurol Res. 2011;33(3):272–7.

    Article  PubMed  Google Scholar 

  31. Tubbs RS, Elton S, Bartolucci AA, Grabb P, Oakes WJ. The position of the conus medullaris in children with a Chiari I malformation. Pediatr Neurosurg. 2000;33(5):249–51.

    Article  CAS  PubMed  Google Scholar 

  32. Tubbs RS, Hill M, Loukas M, Shoja MM, Oakes WJ. Volumetric analysis of the posterior cranial fossa in a family with four generations of the Chiari malformation type I. J Neurosurg Pediatr. 2008;1(1):21–4.

    Article  PubMed  Google Scholar 

  33. Tubbs RS, Loukas M, Shoja MM, Oakes WJ. Observations at the craniocervical junction with simultaneous caudal traction of the spinal cord. Childs Nerv Syst. 2007;23(4):367–9.

    Article  PubMed  Google Scholar 

  34. Sgouros S. Acquired Chiari I malformation in a child with corrected diastematomyelia disappeared after thickened filum division. Pediatr Neurosurg. 2010;46(5):402–5.

    Article  CAS  PubMed  Google Scholar 

  35. Atkinson JL, Weinshenker BG, Miller GM, Piepgras DG, Mokri B. Acquired Chiari I malformation secondary to spontaneous spinal cerebrospinal fluid leakage and chronic intracranial hypotension syndrome in seven cases. J Neurosurg. 1998;88(2):237–42.

    Article  CAS  PubMed  Google Scholar 

  36. Padmanabhan R, Crompton D, Burn D, Birchall D. Acquired Chiari 1 malformation and syringomyelia following lumboperitoneal shunting for pseudotumour cerebri. J Neurol Neurosurg Psychiatry. 2005;76(2):298.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Tubbs RS, Law C, Oakes WJ, Grabb PA. Acquired Chiari I malformation following baclofen pump placement in a child. Case report. J Neurosurg. 2004;101(2 Suppl):211–3.

    PubMed  Google Scholar 

  38. Guillen A, Costa JM. Spontaneous resolution of a Chiari I malformation associated syringomyelia in one child. Acta Neurochir. 2004;146(2):187–91.

    Article  CAS  PubMed  Google Scholar 

  39. Jack CR Jr, Kokmen E, Onofrio BM. Spontaneous decompression of syringomyelia: magnetic resonance imaging findings. Case report. J Neurosurg. 1991;74(2):283–6.

    Article  PubMed  Google Scholar 

  40. Furtado SV, Thakar S, Hegde AS. Correlation of functional outcome and natural history with clinicoradiological factors in surgically managed pediatric Chiari I malformation. Neurosurgery. 2011;68(2):319–28.

    Article  PubMed  Google Scholar 

  41. Benglis D Jr, Covington D, Bhatia R, Bhatia S, Elhammady MS, Ragheb J, et al. Outcomes in pediatric patients with Chiari malformation type I followed up without surgery. J Neurosurg Pediatr. 2011;7(4):375–9.

    Article  PubMed  Google Scholar 

  42. Novegno F, Caldarelli M, Massa A, Chieffo D, Massimi L, Pettorini B, et al. The natural history of the Chiari type I anomaly. J Neurosurg Pediatr. 2008;2(3):179–87.

    Article  PubMed  Google Scholar 

  43. Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJ, Maher CO. Natural history of Chiari malformation type I following decision for conservative treatment. J Neurosurg Pediatr. 2011;8(2):214–21.

    Article  PubMed  Google Scholar 

  44. Nishizawa S, Yokoyama T, Yokota N, Tokuyama T, Ohta S. Incidentally identified syringomyelia associated with Chiari I malformations: is early interventional surgery necessary? Neurosurgery. 2001;49(3):637–41.

    CAS  PubMed  Google Scholar 

  45. Grazzi L, Usai S. Headache and Chiari malformation in young age: clinical aspects and differential diagnosis. Neurol Sci. 2011;32(Suppl 3):299–301.

    Article  Google Scholar 

  46. Alvarez D, Requena I, Arias M, Valdes L, Pereiro I, De la Torre R. Acute respiratory failure as the first sign of Arnold-Chiari malformation associated with syringomyelia. Eur Respir J. 1995;8(4):661–3.

    CAS  PubMed  Google Scholar 

  47. Bullock R, Todd NV, Easton J, Hadley D. Isolated central respiratory failure due to syringomyelia and Arnold-Chiari malformation. BMJ. 1988;297(6661):1448–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Fish DR, Howard RS, Wiles CM, Simon L. Respiratory arrest: a complication of cerebellar ectopia in adults. J Neurol Neurosurg Psychiatry. 1988;51(5):714–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Hamlat A, Helal H, Carsin-Nicol B, Brassier G, Guegan Y, Morandi X. Acute presentation of hydromyelia in a child. Acta Neurochir. 2006;148(10):1117–21.

    Article  CAS  PubMed  Google Scholar 

  50. Quebada PB, Duhaime AC. Chiari malformation type I and a dolichoodontoid process responsible for sudden cardiorespiratory arrest. Case report. J Neurosurg. 2005;103(6 Suppl):567–70.

    PubMed  Google Scholar 

  51. Stephany JD, Garavaglia JC, Pearl GS. Sudden death in a 27-year-old man with Chiari I malformation. Am J Forensic Med Pathol. 2008;29(3):249–50.

    Article  PubMed  Google Scholar 

  52. Tomaszek DE, Tyson GW, Bouldin T, Hansen AR. Sudden death in a child with an occult hindbrain malformation. Ann Emerg Med. 1984;13(2):136–8.

    Article  CAS  PubMed  Google Scholar 

  53. Tsara V, Serasli E, Kimiskidis V, Papagianopoulos S, Katsaridis V, Fylaktakis M, et al. Acute respiratory failure and sleep-disordered breathing in Arnold-Chiari malformation. Clin Neurol Neurosurg. 2005;107(6):521–4.

    Article  PubMed  Google Scholar 

  54. Wellons JC 3rd, Tubbs RS, Bui CJ, Grabb PA, Oakes WJ. Urgent surgical intervention in pediatric patients with Chiari malformation type I. Report of two cases. J Neurosurg. 2007;107(1 Suppl):49–52.

    PubMed  Google Scholar 

  55. Yoshikawa H. Sudden respiratory arrest and Arnold-Chiari malformation. Eur J Paediatr Neurol. 2003;7(4):191.

    Article  PubMed  Google Scholar 

  56. Zager EL, Ojemann RG, Poletti CE. Acute presentations of syringomyelia. Report of three cases. J Neurosurg. 1990;72(1):133–8.

    Article  CAS  PubMed  Google Scholar 

  57. Ziegler DK, Mallonee W. Chiari-1 malformation, migraine, and sudden death. Headache. 1999;39(1):38–41.

    Article  CAS  PubMed  Google Scholar 

  58. Kurup H, Lawrence T, Hargreaves D. Transient quadriparesis following neck injury: presentation of a Chiari I malformation. Eur J Orthop Surg Traumatol. 2005;15:319–21.

    Article  Google Scholar 

  59. Tubbs RS, Beckman J, Naftel RP, Chern JJ, Wellons JC 3rd, Rozzelle CJ, et al. Institutional experience with 500 cases of surgically treated pediatric Chiari malformation type I. J Neurosurg Pediatr. 2011;7(3):248–56.

    Article  PubMed  Google Scholar 

  60. Tubbs RS, Lyerly MJ, Loukas M, Shoja MM, Oakes WJ. The pediatric Chiari I malformation: a review. Childs Nerv Syst. 2007;23(11):1239–50.

    Article  PubMed  Google Scholar 

  61. Guo F, Wang M, Long J, Wang H, Sun H, Yang B, et al. Surgical management of Chiari malformation: analysis of 128 cases. Pediatr Neurosurg. 2007;43(5):375–81.

    Article  PubMed  Google Scholar 

  62. Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, et al. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1999;44(5):1005–17.

    Article  CAS  PubMed  Google Scholar 

  63. Zhang ZQ, Chen YQ, Chen YA, Wu X, Wang YB, Li XG. Chiari I malformation associated with syringomyelia: a retrospective study of 316 surgically treated patients. Spinal Cord. 2008;46(5):358–63.

    Article  CAS  PubMed  Google Scholar 

  64. Krieger MD, McComb JG, Levy ML. Toward a simpler surgical management of Chiari I malformation in a pediatric population. Pediatr Neurosurg. 1999;30(3):113–21.

    Article  CAS  PubMed  Google Scholar 

  65. Saez RJ, Onofrio BM, Yanagihara T. Experience with Arnold-Chiari malformation, 1960 to 1970. J Neurosurg. 1976;45(4):416–22.

    Article  CAS  PubMed  Google Scholar 

  66. Dones J, De Jesus O, Colen CB, Toledo MM, Delgado M. Clinical outcomes in patients with Chiari I malformation: a review of 27 cases. Surg Neurol. 2003;60(2):142–8.

    Article  PubMed  Google Scholar 

  67. Genitori L, Peretta P, Nurisso C, Macinante L, Mussa F. Chiari type I anomalies in children and adolescents: minimally invasive management in a series of 53 cases. Childs Nerv Syst. 2000;16(10–11):707–18.

    Article  CAS  PubMed  Google Scholar 

  68. Navarro R, Olavarria G, Seshadri R, Gonzales-Portillo G, McLone DG, Tomita T. Surgical results of posterior fossa decompression for patients with Chiari I malformation. Childs Nerv Syst. 2004;20(5):349–56.

    Article  PubMed  Google Scholar 

  69. Aghakhani N, Parker F, David P, Morar S, Lacroix C, Benoudiba F, et al. Long-term follow-up of Chiari-related syringomyelia in adults: analysis of 157 surgically treated cases. Neurosurgery. 2009;64(2):308–15.

    Article  PubMed  Google Scholar 

  70. Aydin S, Hanimoglu H, Tanriverdi T, Yentur E, Kaynar MY. Chiari type I malformations in adults: a morphometric analysis of the posterior cranial fossa. Surg Neurol. 2005;64(3):237–41.

    Article  PubMed  Google Scholar 

  71. Armonda RA, Citrin CM, Foley KT, Ellenbogen RG. Quantitative cine-mode magnetic resonance imaging of Chiari I malformations: an analysis of cerebrospinal fluid dynamics. Neurosurgery. 1994;35(2):214–24.

    Article  CAS  PubMed  Google Scholar 

  72. Blagodatsky MD, Larionov SN, Manohin PA, Shanturov VA, Gladyshev YV. Surgical treatment of “hindbrain related” syringomyelia: new data for pathogenesis. Acta Neurochir. 1993;124(2–4):82–5.

    Article  CAS  PubMed  Google Scholar 

  73. Bogdanov EI, Mendelevich EG. Syrinx size and duration of symptoms predict the pace of progressive myelopathy: retrospective analysis of 103 unoperated cases with craniocervical junction malformations and syringomyelia. Clin Neurol Neurosurg. 2002;104(2):90–7.

    Article  CAS  PubMed  Google Scholar 

  74. Cahan LD, Bentson JR. Considerations in the diagnosis and treatment of syringomyelia and the Chiari malformation. J Neurosurg. 1982;57(1):24–31.

    Article  CAS  PubMed  Google Scholar 

  75. Eule JM, Erickson MA, O’Brien MF, Handler M. Chiari I malformation associated with syringomyelia and scoliosis: a twenty-year review of surgical and nonsurgical treatment in a pediatric population. Spine (Phila Pa 1976). 2002;27(13):1451–5.

    Article  Google Scholar 

  76. Hida K, Iwasaki Y, Koyanagi I, Abe H. Pediatric syringomyelia with chiari malformation: its clinical characteristics and surgical outcomes. Surg Neurol. 1999;51(4):383–91.

    Article  CAS  PubMed  Google Scholar 

  77. Oldfield EH, Muraszko K, Shawker TH, Patronas NJ. Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils. Implications for diagnosis and treatment. J Neurosurg. 1994;80(1):3–15.

    Article  CAS  PubMed  Google Scholar 

  78. Pujol J, Roig C, Capdevila A, Pou A, Marti-Vilalta JL, Kulisevsky J, et al. Motion of the cerebellar tonsils in Chiari type I malformation studied by cine phase-contrast MRI. Neurology. 1995;45(9):1746–53.

    Article  CAS  PubMed  Google Scholar 

  79. Menezes AH. Chiari I malformations and hydromyelia–complications. Pediatr Neurosurg. 1991;17(3):146–54.

    Article  PubMed  Google Scholar 

  80. Fischbein NJ, Dillon WP, Cobbs C, Weinstein PR. The “presyrinx” state: a reversible myelopathic condition that may precede syringomyelia. AJNR Am J Neuroradiol. 1999;20(1):7–20.

    CAS  PubMed  Google Scholar 

  81. Goh S, Bottrell CL, Aiken AH, Dillon WP, Wu YW. Presyrinx in children with Chiari malformations. Neurology. 2008;71(5):351–6.

    Article  CAS  PubMed  Google Scholar 

  82. Levy EI, Heiss JD, Kent MS, Riedel CJ, Oldfield EH. Spinal cord swelling preceding syrinx development. Case report. J Neurosurg. 2000;92(1 Suppl):93–7.

    CAS  PubMed  Google Scholar 

  83. Stovner LJ, Rinck P. Syringomyelia in Chiari malformation: relation to extent of cerebellar tissue herniation. Neurosurgery. 1992;31(5):913–7.

    Article  CAS  PubMed  Google Scholar 

  84. Pillay PK, Awad IA, Little JR, Hahn JF. Symptomatic Chiari malformation in adults: a new classification based on magnetic resonance imaging with clinical and prognostic significance. Neurosurgery. 1991;28(5):639–45.

    Article  CAS  PubMed  Google Scholar 

  85. Sudo K, Doi S, Maruo Y, Tashiro K, Terae S, Miyasaka K, et al. Syringomyelia with spontaneous resolution. J Neurol Neurosurg Psychiatry. 1990;53(5):437–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Sudo K, Tashiro K, Isu T. Spontaneous drainage in syringomyelia. J Neurosurg. 1994;80(5):950–1.

    CAS  PubMed  Google Scholar 

  87. Bunc G, Vorsic M. Presentation of a previously asymptomatic Chiari I malformation by a flexion injury to the neck. J Neurotrauma. 2001;18(6):645–8.

    Article  CAS  PubMed  Google Scholar 

  88. Callaway GH, O’Brien SJ, Tehrany AM. Chiari I malformation and spinal cord injury: cause for concern in contact athletes? Med Sci Sports Exerc. 1996;28(10):1218–20.

    Article  CAS  PubMed  Google Scholar 

  89. Harrell BR, Barootes BG. The type I Chiari malformation in a previously asymptomatic college athlete: addressing the issue of return to athletic participation. Clin J Sport Med. 2010;20(3):215–7.

    Article  PubMed  Google Scholar 

  90. Riviello JJ Jr, Marks HG, Faerber EN, Steg NL. Delayed cervical central cord syndrome after trivial trauma. Pediatr Emerg Care. 1990;6(2):113–7.

    Article  PubMed  Google Scholar 

  91. Wan MJ, Nomura H, Tator CH. Conversion to symptomatic Chiari I malformation after minor head or neck trauma. Neurosurgery. 2008;63(4):748–53.

    Article  PubMed  Google Scholar 

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The author would like to thank Holly Wagner for providing editorial assistance.

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Maher, C.O. (2020). Natural History of Chiari Malformations. In: Tubbs, R., Turgut, M., Oakes, W. (eds) The Chiari Malformations. Springer, Cham. https://doi.org/10.1007/978-3-030-44862-2_22

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