Assessing the Prevalence of Ectopic Cerebellar Tonsils and Accompanying Symptoms in Individuals with Various Headaches

Objectives: Chiari malformation exhibits well-defined clinical signs, symptoms, and incidence rates in clinical studies. However, cerebellar tonsil ectopia presents with ambiguous symptoms and undetermined incidence rates in numerous studies. Our objective was to determine the incidence of cerebella...

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Main Authors: Ghodsiyeh Azarkar, Sahar Nemati, Shabnam Vafadar, Gholam Reza Sharifzade, Arash Ziaee, Hossein Ashrafi
Format: Article
Language:English
Published: Ubiquity Press 2023-10-01
Series:Journal of the Belgian Society of Radiology
Subjects:
Online Access:https://account.jbsr.be/index.php/up-j-jbsr/article/view/3264
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author Ghodsiyeh Azarkar
Sahar Nemati
Shabnam Vafadar
Gholam Reza Sharifzade
Arash Ziaee
Hossein Ashrafi
author_facet Ghodsiyeh Azarkar
Sahar Nemati
Shabnam Vafadar
Gholam Reza Sharifzade
Arash Ziaee
Hossein Ashrafi
author_sort Ghodsiyeh Azarkar
collection DOAJ
description Objectives: Chiari malformation exhibits well-defined clinical signs, symptoms, and incidence rates in clinical studies. However, cerebellar tonsil ectopia presents with ambiguous symptoms and undetermined incidence rates in numerous studies. Our objective was to determine the incidence of cerebellar tonsil ectopia in individuals with headaches and identify additional clinical symptoms. This aims to improve diagnosis accuracy for clinicians and neurologists, leading to more effective treatment approaches. Methods: A cross-sectional study conducted in 2022 included 2305 participants aged 4–78 years presenting with headache. Chiari malformation was diagnosed using magnetic resonance imaging (MRI) scans, with a definition of cerebellar tonsil herniation extending beyond 5mm into the cervical canal. Results: The prevalence of Chiari malformation was 3.4%, with no significant gender difference (p = 0.72). There was a significant correlation between Chiari malformation and headache exacerbation due to the Valsalva maneuver (p < 0.001) and the presence of vertigo (p < 0.001). No significant association was found between Chiari malformation and accompanying symptoms such as nausea (p = 0.43), photophobia (p = 0.2), phonophobia (p = 0.52), and speech disorders (p = 0.45). Conclusion: These findings suggest a notable prevalence of Chiari malformation among headache patients and its association with specific headache characteristics, such as acute and occipital headaches, exacerbation by the Valsalva maneuver, and the co-occurrence of vertigo. These results underscore the need to consider Chiari malformation in the differential diagnosis of patients presenting with these specific headache features.
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spelling doaj.art-4e3a9f19aa0c471b81de1bde68391e962023-11-23T09:12:08ZengUbiquity PressJournal of the Belgian Society of Radiology2514-82812023-10-011071808010.5334/jbsr.32643258Assessing the Prevalence of Ectopic Cerebellar Tonsils and Accompanying Symptoms in Individuals with Various HeadachesGhodsiyeh Azarkar0https://orcid.org/0000-0003-2603-5255Sahar Nemati1https://orcid.org/0009-0006-8470-1104Shabnam Vafadar2https://orcid.org/0000-0002-4813-1750Gholam Reza Sharifzade3https://orcid.org/0000-0003-4812-0223Arash Ziaee4https://orcid.org/0000-0002-3952-0738Hossein Ashrafi5https://orcid.org/0009-0000-1047-8938Infectious Diseases Research Center, Birjand University of Medical SciencesDepartment of audiology, razi Hospital, Birjand University of Medical Sciences, BirjandDepartment of neurology, razi Hospital, Birjand University of Medical Sciences, BirjandDepartment of Community Medicine, Faculty of Health, Birjand University of Medical Sciences, BirjandStudent Research Committee, Faculty of Medicine, Mashhad University of Medical SciencesDepartment of Radiology, Valiasr Hospital, Birjand University of Medical Sciences, BirjandObjectives: Chiari malformation exhibits well-defined clinical signs, symptoms, and incidence rates in clinical studies. However, cerebellar tonsil ectopia presents with ambiguous symptoms and undetermined incidence rates in numerous studies. Our objective was to determine the incidence of cerebellar tonsil ectopia in individuals with headaches and identify additional clinical symptoms. This aims to improve diagnosis accuracy for clinicians and neurologists, leading to more effective treatment approaches. Methods: A cross-sectional study conducted in 2022 included 2305 participants aged 4–78 years presenting with headache. Chiari malformation was diagnosed using magnetic resonance imaging (MRI) scans, with a definition of cerebellar tonsil herniation extending beyond 5mm into the cervical canal. Results: The prevalence of Chiari malformation was 3.4%, with no significant gender difference (p = 0.72). There was a significant correlation between Chiari malformation and headache exacerbation due to the Valsalva maneuver (p < 0.001) and the presence of vertigo (p < 0.001). No significant association was found between Chiari malformation and accompanying symptoms such as nausea (p = 0.43), photophobia (p = 0.2), phonophobia (p = 0.52), and speech disorders (p = 0.45). Conclusion: These findings suggest a notable prevalence of Chiari malformation among headache patients and its association with specific headache characteristics, such as acute and occipital headaches, exacerbation by the Valsalva maneuver, and the co-occurrence of vertigo. These results underscore the need to consider Chiari malformation in the differential diagnosis of patients presenting with these specific headache features.https://account.jbsr.be/index.php/up-j-jbsr/article/view/3264chiari malformationcerebellar tonsil ectopiaheadachevertigonausea
spellingShingle Ghodsiyeh Azarkar
Sahar Nemati
Shabnam Vafadar
Gholam Reza Sharifzade
Arash Ziaee
Hossein Ashrafi
Assessing the Prevalence of Ectopic Cerebellar Tonsils and Accompanying Symptoms in Individuals with Various Headaches
Journal of the Belgian Society of Radiology
chiari malformation
cerebellar tonsil ectopia
headache
vertigo
nausea
title Assessing the Prevalence of Ectopic Cerebellar Tonsils and Accompanying Symptoms in Individuals with Various Headaches
title_full Assessing the Prevalence of Ectopic Cerebellar Tonsils and Accompanying Symptoms in Individuals with Various Headaches
title_fullStr Assessing the Prevalence of Ectopic Cerebellar Tonsils and Accompanying Symptoms in Individuals with Various Headaches
title_full_unstemmed Assessing the Prevalence of Ectopic Cerebellar Tonsils and Accompanying Symptoms in Individuals with Various Headaches
title_short Assessing the Prevalence of Ectopic Cerebellar Tonsils and Accompanying Symptoms in Individuals with Various Headaches
title_sort assessing the prevalence of ectopic cerebellar tonsils and accompanying symptoms in individuals with various headaches
topic chiari malformation
cerebellar tonsil ectopia
headache
vertigo
nausea
url https://account.jbsr.be/index.php/up-j-jbsr/article/view/3264
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