Arnold — Chiari anomaly: what to pay attention to | Ukrainian Medical Journal

The article describes a clinical case from the practice of a neurologist, diagnosing Arnold — Chiari anomaly in a patient with cardiovascular pathology. The basis of the clinical picture was attacks of pronounced headache in the occipital region with increased blood pressure, nausea, sometimes vomiting. For a long time, the patient was treated by a family doctor due to the presence of hypertension, but there was no effect when taking combined antihypertensive therapy. Thanks to the combined efforts of specialists of various medical specialties, the correct basic diagnosis was established and subsequent treatment tactics were adjusted. In this regard, it became necessary to draw the attention of doctors of various specialties, primarily family doctors, therapists, cardiologists, neurologists, that the above clinical symptoms can be caused not only by widespread pathologies of internal organs, for example, hypertension, but also by a rarer form of neurological and neurosurgical diseases, such as Arnold — Chiari anomaly, and they can also be associated in the same patient.

References

1. Sarnat H.B. (2008) Disorders of segmentation of the neural tube: Chiari malformations. Handb. Clin. Neurol., 7: 89–103. doi: 10.1016/S0072-9752(07)87006-0.
2. Schijman E. (2004) History, anatomic forms, and pathogenesis of Chiari I malformations. Child’s Nervous System, 20(5): 323–328. doi:10.1007/s00381-003-0878-y.
3. Дзяк Л.А., Зорин Н.А., Егоров В.Ф., Чередниченко Ю.В. (2001) Мальформация Арнольда-Киари: классификация, этиопатогенез, клиника, диагностика (обзор литературы). Укр. нейрохірургічний журн., 1: 17–23.
4. Sarnat H.B. (2004) Regional ependymal upregulation of vimentin in Chiari II malformation, aqueductal stenosis, and hydromyelia. Pediatr. Dev. Pathol., 7(1): 48–60.
5. Menezes A.H. (1999) Primary craniovertebral anomalies and the hindbrain herniation syndrome (Chiari I): data base analysis. Pediatr. Neurosurg., 23: 260–269.
6. Вернигородський С.В. Арнольда — Кіарі синдром. Велика українська енциклопедія. URL: vue.gov.ua/Арнольда — Кіарі синдром.
7. Van Dellen J.R. (2021) Chiari Malformation: An Unhelpful Eponym. World Neurosurg., 156: 1–3. doi:10.1016/j.wneu.2021.08.100.
8. Schwartz E.D. (2023) Intracranial MRI findings of a child with a Chiari II malformation. https://www.uptodate.com
9. Steinbok P. (2004) Clinical features of Chiari I malformations. Childs Nerv. Syst., 20(5): 329–331. doi: 10.1007/s00381-003-0879-x.
10. Ciaramitaro P., Ferraris M., Massaro F., Garbossa D. (2019) Clinical diagnosis-part I: what is really caused by Chiari I. Childs Nerv. Syst., 35(10): 1673–1679.
11. Leu R.M. (2015) Sleep-Related Breathing Disorders and the Chiari 1 Malformation. Chest, 148(5): 1346–1352. doi: 10.1378/chest.14-3090.
12. Goh S., Bottrell C.L., Aiken A.H. et al. (2008) Presyrinx in children with Chiari malformations. Neurology, 71(5): 351–356. doi: 10.1212/01.wnl.0000304087.91204.95.
13. Pakzaban P. (2018) Chiari malformation. Medscape.