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Chiari I Malformation - Relationship to an Accident

The relationship of an accident with physical trauma through chiari I malformation is the subject of controversy. Many people with chiari I malformation that either knew they had it or never knew they had it and suffered no symptoms of the chiari I malformation have tremendous symptoms after trauma particularly head and neck trauma such as from a car accident.

Chiari I malformation is a condition in which the boney space enclosing the lower part of the brain is smaller than normal causing the cerebellar tonsils to push through the skull and down into the spinal canal. This means that part of the cerebellum drops down into the spinal canal.

Most chiari I malformations are considered to be congenital, meaning that people are born with this structural defect. However it is possible that extreme trauma can actually cause the cerebellar tonsils to herniate and drop down into the spinal canal. This would be the rare case where the accident with trauma causes the chiari I malformation.

However the normal relationship between an accident with trauma and the chiari I malformation exists when the chiari I malformation is congenital and not caused by the trauma but is also asymptomatic and the trauma causes a worsening of the condition causing symptoms.

This can be seen in trauma cases such as car accidents when the neck and head are injured sustaining severe acceleration/deceleration movements causing injury such as from a severe whiplash.

Symptoms occur when the cerebellar tonsils drop down into the spinal canal worsening as aggravated by the trauma causing the cerebrospinal fluid (CSF) to be blocked stopping the normal flow of the CSF into the brain. When this happens the CSF begins to force its way through pushing the tonsils down even further causing more symptoms.

The symptoms can be as follows:

• Severe headaches

• Neck pain

• Dizziness and balance problems

• Numbness in the hands

• Sleep problems

Another condition that can occur in the spinal canal in addition to the chiari I malformation and the cerebellar tonsils blocking the CSF fluid is that of sringomyelia. This is a condition where a cyst or syrinx forms that is filled with the CSF fluid in the spinal canal causing further symptoms as above listed.

When the chiari I malformation is symptomatic with or without sringomyelia decompression surgery can be performed in the back of the patients head to create more space around the chiari I malformation relieving compression and placing the cerebellum back into its proper position no longer blocking the spinal canal.

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