Pérez NFR, Hernández LO, Bermejo SJC, Ríos CMC, Ortíz MM

Language: Spanish
References: 13
Page: 147-151
PDF size: 221.25 Kb.

ABSTRACT

Introduction: type I Chiari malformation was described in 1891 by Hanz Chiari. It is characterized by an ectopia or descent of the cerebellar tonsils through the foramen magnum. This malformation more often occurs in adolescence or adulthood. Patients may be asymptomatic or present neurological symptoms that include: headache, neck pain, ataxia, dizziness, hemiparesis or long-ways syndrome, among others, depending on the degree of descent and associated pathologies. Pure unilateral ectopy is rarely found, thus why this clinical case is reported.
Case report: a 46 year-old patient, with a history of sub-occipital headache of 2-year evolution, progressive loss of muscle strength of the right hemisphere with attitude trembling, more marked on the right arm and gait difficulty. A cranial magnetic resonance [MR] was indicated, visualizing a descent of 9mm in the left cerebellar tonsil. Decompressive craniectomy of the posterior fossa was performed, more lateralized to the left, osteotomy of the posterior arch of the atlas along with the internal dural expanding; showing satisfactory progress.
Conclusions: asymmetrical Chiari type-I malformation is frequent, but not much medical literature on the subject is found, asymmetry may trigger unilateral symptoms. The unilateral amygdaloid hypertrophy is a rare entity, which may be associated with type-I Chiari malformation.

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