Headache associated with the Chiari type I malformation

Publicado na 4ª edição de 2008

The aim of this study was to perform a brief review of the literature on headache associated with the Chiari type 1 malformation (CM-1). The clinical presentation of CM-1 is very varied. It may be asymptomatic or progress as a medullary syndrome affecting the long motor pathways with spasticity of all four limbs, cerebellar syndrome, deglutition difficulty, dysarthria and night apnea. Patients may also present cervical and head pain characterized by headaches that are triggered by the Valsalva maneuver and physical effort. A diagnosis of CM-1 is readily made by the use of MRI showing the hernia of the cerebellar tonsils through the foramen magnum. Several series of patients have shown a high frequency of headache in these with CM-1. The headache spectrum includes short duration headache associated with coughing, effort headache, headache associated with low pressure of the cerebrospinal fluid, longduration headache with the characteristics of cervicogenic headache, and a continuous type of headache. No specific headache type is linked to CM-1, although it is the headache with coughing that is found in the highest percentage of patients.

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