Chiari’s malformation of the cranio-cervical union. Case report

Abstract

Introduction: Arnold Chiari's malformation is an odd disease, characterized for the presence of insidious symptoms that can suppose a delay in the diagnosis; it consists, essentially, of a cluster of nerve structures of the posterior fossa (cerebellum, swelling and medulla oblongata), which tend to move caudally through the foramen magnum.

Objective: to present a case treated by the Cuban Medical Mission in Timor Leste, with compatible symptoms with cranio-cervical Chiari’s malformation, which is of importance for being a rare entity in medical practice and, due to its characteristics and the revision adopted in literature, could be useful as reference material for the collaborators of the Cuban Medical Mission.

Case report: patient of 14 years old, male, mestizo, who was admitted with signs of sensitive brachial neuritis, so initially suspected the existence of a brain tumor; during his stay in the room he showed difficulty in walking, speech disorder, sialorrhea, and occasional vomiting. In the physical and radiological examinations was confirmed the presence of hydrocephalus, alterations of the cervical spine and compatible signs with pyramidal and cranial nerves commitment; a Chiari’s malformation of the cranio-cervical union was diagnosed.

Conclusions: the patient has different symptoms and signs common to Chiari’s malformation of the cranio-cervical union; in this particular case it is noteworthy that, unlike what the literature reports on the subject, the patient had no seizures or mental retardation.