Skip to main content
SpringerLink
Log in

Chiari Malformations and Other Anomalies

  • Chapter
Head and Neck Injuries in Young Athletes

Part of the book series: Contemporary Pediatric and Adolescent Sports Medicine ((PASM))

  • 1036 Accesses

Abstract

Athletes are certainly susceptible to sports-specific injuries, but like any other patient, they may also harbor underlying congenital and acquired spinal cord and brain anomalies that may complicate their care and return to play. Chiari malformations, spinal cord cysts and syringes, tethered spinal cord, and spinal cord tumors are some of the pathologies that may be preexisting or detected in an evaluation after a sports-related injury. In this age of increased medical imaging, many of these anomalies are found incidentally in patients who are often asymptomatic. In this chapter, we review the essential background about these anomalies, evaluation techniques, possible treatments, and requirements for the return of these athletes to their sport of choice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 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 

  2. 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 

  3. Miele VJ, Bailes JE, Martin NA. Participation in contact or collision sports in athletes with epilepsy, genetic risk factors, structural brain lesions, or history of craniotomy. Neurosurg Focus. 2006;21(4):E9.

    PubMed  Google Scholar 

  4. Meehan 3rd WP, Jordaan M, Prabhu SP, Carew L, Mannix RC, Proctor MR. Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low. Clin J Sport Med. 2015;25(2):133–7.

    Article  PubMed  Google Scholar 

  5. Novegno F, Caldarelli M, Massa A, et al. The natural history of the Chiari Type I anomaly. J Neurosurg Pediatr. 2008;2(3):179–87.

    Article  PubMed  Google Scholar 

  6. Marin-Padilla M. Cephalic axial skeletal-neural dysraphic disorders: embryology and pathology. Can J Neurol Sci. 1991;18(2):153–69.

    CAS  PubMed  Google Scholar 

  7. Marin-Padilla M, Marin-Padilla TM. Morphogenesis of experimentally induced Arnold—Chiari malformation. J Neurol Sci. 1981;50(1):29–55.

    Article  CAS  PubMed  Google Scholar 

  8. 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 

  9. Khatwa U, Ramgopal S, Mylavarapu A, et al. MRI findings and sleep apnea in children with Chiari I malformation. Pediatr Neurol. 2013;48(4):299–307.

    Article  PubMed  Google Scholar 

  10. 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 

  11. Chiapparini L, Saletti V, Solero CL, Bruzzone MG, Valentini LG. Neuroradiological diagnosis of Chiari malformations. Neurol Sci. 2011;32 Suppl 3:S283–6.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  13. Tubbs RS, Pugh JA, Oakes WJ. Chiari malformations. In: Winn HR, editor. Youmans neurological surgery. 6th ed. New York: Elsevier; 2011. p. 1918–27.

    Google Scholar 

  14. Hofmann E, Warmuth-Metz M, Bendszus M, Solymosi L. Phase-contrast MR imaging of the cervical CSF and spinal cord: volumetric motion analysis in patients with Chiari I malformation. Am J Neuroradiol. 2000;21(1):151–8.

    CAS  PubMed  Google Scholar 

  15. 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 

  16. 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):214–23; discussion 223–4.

    Article  CAS  PubMed  Google Scholar 

  17. Rocque BG, George TM, Kestle J, Iskandar BJ. Treatment practices for Chiari malformation type I with syringomyelia: results of a survey of the American Society of Pediatric Neurosurgeons. J Neurosurg Pediatr. 2011;8(5):430–7.

    Article  PubMed  Google Scholar 

  18. Wan MJ, Nomura H, Tator CH. Conversion to symptomatic Chiari I malformation after minor head or neck trauma. Neurosurgery. 2008;63(4):748–53; discussion 753.

    Article  PubMed  Google Scholar 

  19. Yarbrough CK, Powers AK, Park TS, Leonard JR, Limbrick DD, Smyth MD. Patients with Chiari malformation Type I presenting with acute neurological deficits: case series. J Neurosurg Pediatr. 2011;7(3):244–7.

    Article  PubMed  Google Scholar 

  20. 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 

  21. Makela JP. Arnold-Chiari malformation type I in military conscripts: symptoms and effects on service fitness. Mil Med. 2006;171(2):174–6.

    Article  PubMed  Google Scholar 

  22. Benglis Jr D, Covington D, Bhatia R, 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 

  23. Magge SN, Smyth MD, Governale LS, et al. Idiopathic syrinx in the pediatric population: a combined center experience. J Neurosurg Pediatr. 2011;7(1):30–6.

    Article  PubMed  Google Scholar 

  24. Frogameni AD, Widoff BE, Jackson DW. Syringomyelia causing acute hemiparesis in a college football player. Orthopedics. 1994;17(6):552–3.

    CAS  PubMed  Google Scholar 

  25. 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 

  26. Batzdorf U, Klekamp J, Johnson JP. A critical appraisal of syrinx cavity shunting procedures. J Neurosurg. 1998;89(3):382–8.

    Article  CAS  PubMed  Google Scholar 

  27. Roy AK, Slimack NP, Ganju A. Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management. Neurosurg Focus. 2011;31(6):E15.

    Article  PubMed  Google Scholar 

  28. Singhal A, Bowen-Roberts T, Steinbok P, Cochrane D, Byrne AT, Kerr JM. Natural history of untreated syringomyelia in pediatric patients. Neurosurg Focus. 2011;31(6):E13.

    Article  PubMed  Google Scholar 

  29. Evangelou P, Meixensberger J, Bernhard M, et al. Operative management of idiopathic spinal intradural arachnoid cysts in children: a systematic review. Childs Nerv Syst. 2013;29(4):657–64.

    Article  PubMed  Google Scholar 

  30. Lucantoni C, Than KD, Wang AC, et al. Tarlov cysts: a controversial lesion of the sacral spine. Neurosurg Focus. 2011;31(6):E14.

    Article  PubMed  Google Scholar 

  31. Hertzler 2nd DA, DePowell JJ, Stevenson CB, Mangano FT. Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus. 2010;29(1):E1.

    Article  PubMed  Google Scholar 

  32. Filippidis AS, Kalani MY, Theodore N, Rekate HL. Spinal cord traction, vascular compromise, hypoxia, and metabolic derangements in the pathophysiology of tethered cord syndrome. Neurosurg Focus. 2010;29(1):E9.

    Article  PubMed  Google Scholar 

  33. Kim AH, Kasliwal MK, McNeish B, Silvera VM, Proctor MR, Smith ER. Features of the lumbar spine on magnetic resonance images following sectioning of filum terminale. J Neurosurg Pediatr. 2011;8(4):384–9.

    Article  PubMed  Google Scholar 

  34. Maher CO, Bauer SB, Goumnerova L, Proctor MR, Madsen JR, Scott RM. Urological outcome following multiple repeat spinal cord untethering operations. Clinical article. J Neurosurg Pediatr. 2009;4(3):275–9.

    Article  PubMed  Google Scholar 

  35. Hsieh PC, Stapleton CJ, Moldavskiy P, et al. Posterior vertebral column subtraction osteotomy for the treatment of tethered cord syndrome: review of the literature and clinical outcomes of all cases reported to date. Neurosurg Focus. 2010;29(1):E6.

    Article  PubMed  Google Scholar 

  36. Bailes JE, Petschauer M, Guskiewicz KM, Marano G. Management of cervical spine injuries in athletes. J Athl Train. 2007;42(1):126–34.

    PubMed Central  PubMed  Google Scholar 

  37. Bailes JE. Experience with cervical stenosis and temporary paralysis in athletes. J Neurosurg Spine. 2005;2(1):11–6.

    Article  PubMed  Google Scholar 

  38. Vaccaro AR, Klein GR, Ciccoti M, et al. Return to play criteria for the athlete with cervical spine injuries resulting in stinger and transient quadriplegia/paresis. Spine J. 2002;2(5):351–6.

    Article  PubMed  Google Scholar 

  39. Proctor MR, Cantu RC. Head and neck injuries in young athletes. Clin Sports Med. 2000;19(4):693–715.

    Article  CAS  PubMed  Google Scholar 

  40. Dailey A, Harrop JS, France JC. High-energy contact sports and cervical spine neuropraxia injuries: what are the criteria for return to participation? Spine. 2010;35(21 Suppl):S193–201.

    Article  PubMed  Google Scholar 

  41. O’Brien M, Curtis C, D’Hemecourt P, Proctor M. Case report: a case of persistent back pain and constipation in a 5-year-old boy. Phys Sportsmed. 2009;37(1):133–7.

    Article  PubMed  Google Scholar 

  42. Hermann DM, Barth A, Porchet F, Hess CW, Mumenthaler M, Bassetti CL. Nocturnal positional lumboischialgia: presenting symptom of lumbar spinal tumours. J Neurol. 2008;255(11):1836–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Brigham and Women’s Hospital/Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Muhammad M. Abd-El-Barr MD, PhD

  2. Boston Children’s Hospital/Harvard Medical School, Boston, MA, USA

    Mark R. Proctor MD (Vice-Chair of Neurosurgery)

Authors
  1. Muhammad M. Abd-El-Barr MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark R. Proctor MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Muhammad M. Abd-El-Barr MD, PhD .

Editor information

Editors and Affiliations

  1. Division of Sports Medicine, Childrens Hospital Boston, Boston, Massachusetts, USA

    Michael O'Brien

  2. The Micheli Center for Sports Injur , Waltham, Massachusetts, USA

    William P. Meehan III

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Abd-El-Barr, M.M., Proctor, M.R. (2016). Chiari Malformations and Other Anomalies. In: O'Brien, M., Meehan III, W. (eds) Head and Neck Injuries in Young Athletes. Contemporary Pediatric and Adolescent Sports Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-23549-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-23549-3_8

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23548-6

  • Online ISBN: 978-3-319-23549-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation