Chiari Malformation in a Collegiate Football Player
Professor Margaret Frens
This is a case study on the topic of Type I Chiari Malformation in a Collegiate Football Player, occurring with many other complex associations. Chiari Malformation is defined as the caudal descent of the cerebellar tonsil through the foramen magnum measuring more than three to five millimeters. Chiari I malformations are often isolated abnormalities, however, in this case it is associated with cervical cord syrinx, platybasia, headaches, and cervical spine instability. Cervical cord syrinx, also known as hydrosyringomyelia, is characterized as a collection of cerebral spinal fluid inside the central canal of the spinal cord. Cervical cord syrinx can cause flaccid weakness of the upper extremity and cause a “cape-like” distribution of pain and sensory loss through the neck and shoulders. Platybasia is defined as an abnormal flattening of the base of the skull. This is measured by a base skull angle greater than 143 degrees. Platybasia is common in patients with Chiari I Malformation. In this case, the Chiari is resolved with a posterior fossa decompression and a fusion of the first three cervical vertebrae, C1 to C3. This project reviews the correction method as well as limitations to returning to high-contact athletics according to the National Athletic Trainers’ Association Position Statement: Preparticipation Physical Examinations and Disqualifying Conditions in 2014.
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