Spontaneous Resolution of Aberrant Cerebellar Tonsil Movement in a Patient with Improving Chiari I Malformation
Chiari malformation Type 1 (CMI) is traditionally characterized as a descent of the cerebellar tonsils more than 5mm below the foramen magnum. In some patients with CMI, there is aberrant pulsatile movement of the tonsils downward during cardiac systole which can affect cerebrospinal fluid (CSF) flo...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043322004757 |
| _version_ | 1818471728473440256 |
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| author | Ryan Morgan, BS Reagan A. Collins, BA Taha Hassan, BS Roy Jacob, MD Laszlo Nagy, MD |
| author_facet | Ryan Morgan, BS Reagan A. Collins, BA Taha Hassan, BS Roy Jacob, MD Laszlo Nagy, MD |
| author_sort | Ryan Morgan, BS |
| collection | DOAJ |
| description | Chiari malformation Type 1 (CMI) is traditionally characterized as a descent of the cerebellar tonsils more than 5mm below the foramen magnum. In some patients with CMI, there is aberrant pulsatile movement of the tonsils downward during cardiac systole which can affect cerebrospinal fluid (CSF) flow at the foramen magnum. Here, we present an 18-year-old female patient with CMI who presented with worsening symptoms of her CMI. Magnetic resonance imaging (MRI) at this time indicated an increase in cerebellar tonsil movement and decreased CSF flow at the foramen magnum. At her follow-up appointment, she had complete resolution of the aberrant motion of her tonsils and CSF flow returned to baseline without surgical intervention. Her symptoms also improved during this time, and she is now able to be followed by her primary care physician. The increased pulsatile movement of cerebellar tonsils in patients with CMI has been linked to diminished CSF flow at the foramen magnum and symptom severity. Spontaneous resolution of CMI is rare and has only ever been documented as ascension of the cerebellar tonsils. This case describes restoration of normal tonsil movement and baseline CSF flow corresponding with a resolution of symptoms where a complete resolution in tonsillar ectopia was not present. |
| first_indexed | 2024-04-14T03:55:32Z |
| format | Article |
| id | doaj.art-848a0f81bb4e4833a4baf709f926b99e |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-04-14T03:55:32Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-848a0f81bb4e4833a4baf709f926b99e2022-12-22T02:13:50ZengElsevierRadiology Case Reports1930-04332022-09-0117932473250Spontaneous Resolution of Aberrant Cerebellar Tonsil Movement in a Patient with Improving Chiari I MalformationRyan Morgan, BS0Reagan A. Collins, BA1Taha Hassan, BS2Roy Jacob, MD3Laszlo Nagy, MD4Texas Tech University Health Sciences Center School of Medicine, 3601 4th St, Lubbock, TX 79430, USA; Corresponding author.Texas Tech University Health Sciences Center School of Medicine, 3601 4th St, Lubbock, TX 79430, USATexas Tech University Health Sciences Center School of Medicine, 3601 4th St, Lubbock, TX 79430, USAUniversity Medical Center Department of Radiology, 602 Indiana Ave, Lubbock, TX 79415, USACovenant Medical Center, Department of Pediatrics, 4015 22nd Pl, Lubbock, TX 79410, USAChiari malformation Type 1 (CMI) is traditionally characterized as a descent of the cerebellar tonsils more than 5mm below the foramen magnum. In some patients with CMI, there is aberrant pulsatile movement of the tonsils downward during cardiac systole which can affect cerebrospinal fluid (CSF) flow at the foramen magnum. Here, we present an 18-year-old female patient with CMI who presented with worsening symptoms of her CMI. Magnetic resonance imaging (MRI) at this time indicated an increase in cerebellar tonsil movement and decreased CSF flow at the foramen magnum. At her follow-up appointment, she had complete resolution of the aberrant motion of her tonsils and CSF flow returned to baseline without surgical intervention. Her symptoms also improved during this time, and she is now able to be followed by her primary care physician. The increased pulsatile movement of cerebellar tonsils in patients with CMI has been linked to diminished CSF flow at the foramen magnum and symptom severity. Spontaneous resolution of CMI is rare and has only ever been documented as ascension of the cerebellar tonsils. This case describes restoration of normal tonsil movement and baseline CSF flow corresponding with a resolution of symptoms where a complete resolution in tonsillar ectopia was not present.http://www.sciencedirect.com/science/article/pii/S1930043322004757Chiari malformationSpontaneous resolutionCerebrospinal fluidCerebellar tonsilsBrain motionCine-phase contrast MRI |
| spellingShingle | Ryan Morgan, BS Reagan A. Collins, BA Taha Hassan, BS Roy Jacob, MD Laszlo Nagy, MD Spontaneous Resolution of Aberrant Cerebellar Tonsil Movement in a Patient with Improving Chiari I Malformation Radiology Case Reports Chiari malformation Spontaneous resolution Cerebrospinal fluid Cerebellar tonsils Brain motion Cine-phase contrast MRI |
| title | Spontaneous Resolution of Aberrant Cerebellar Tonsil Movement in a Patient with Improving Chiari I Malformation |
| title_full | Spontaneous Resolution of Aberrant Cerebellar Tonsil Movement in a Patient with Improving Chiari I Malformation |
| title_fullStr | Spontaneous Resolution of Aberrant Cerebellar Tonsil Movement in a Patient with Improving Chiari I Malformation |
| title_full_unstemmed | Spontaneous Resolution of Aberrant Cerebellar Tonsil Movement in a Patient with Improving Chiari I Malformation |
| title_short | Spontaneous Resolution of Aberrant Cerebellar Tonsil Movement in a Patient with Improving Chiari I Malformation |
| title_sort | spontaneous resolution of aberrant cerebellar tonsil movement in a patient with improving chiari i malformation |
| topic | Chiari malformation Spontaneous resolution Cerebrospinal fluid Cerebellar tonsils Brain motion Cine-phase contrast MRI |
| url | http://www.sciencedirect.com/science/article/pii/S1930043322004757 |
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