Concluded Case

Chiari 1 Malformation

16 yr ,F ,No known comorbidities, presented with occipital and upper cervical pain mostly while lying down. Dull aching type of pain with out any associated findings.Most of the days she has difficulty in sleep onset,taking longer time to get sleep . Pain is mostly while lying down and occasionally while writing and using mobile for longer time and while flexing the head and neck. Zone exam ,no external stigmata for a neurocutaneous syndrome or CVJ anomaly. She has no focal neurological deficits also. Diagnosis and management?

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Concluded answer
Thanks Curofy and others who answered the case. Screening of brain and spine - normal. MRI CVJ : Shows features of herniation of cerebellar tonsil 8 mm from foramen magnum. No mass effect on craniomedullary junction. Imp Chiari 1 malformation
All Answers
Thanks Curofy and others who answered the case. Screening of brain and spine - normal. MRI CVJ : Shows features of herniation of cerebellar tonsil 8 mm from foramen magnum. No mass effect on craniomedullary junction. Imp Chiari 1 malformation
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Thanks Curofy
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Mam, dynamic CT CVJ is needed to rule out any instability at CVJ. As pain is experienced in occipital region, it's probably due to C2 nerve root compression.
Chiari malformation. Get ncct head done to look for hydrocephalus. May need foramen magnum decompression
As csf sleeve can be seen behind tonsil in T2 image. its unlikely that FMD is needed.
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Idiopathic intracranial hypertension to be ruled out... let us know whether papilloedema is present??
Is there Arnold chiari malformation? Rule out Syringomyelia Radiologist report?
Screening of spine - No syringomyelia
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