[Klippel-Trénaunay syndrome and Arnold-Chiari type I malformation].

magnetic resonance findings described above. The most common symptoms are occipital headache, triggered by Valsalva maneuver or neck extension, retroorbital pain, and visual disorders or symptoms simulating Ménière disease with hearing loss, vertigo, and tinnitus.5 Additionally, compression of the brainstem can lead to hydrocephalus or syringomyelia in up to 40% of cases.6 We describe a 54-year-old patient with a history of thalassemia minor who had undergone surgery for L5-S1 disc herniation as well as for a tumor of the right parietal bone in 2000, for which no written reports were provided. Following a dermatological assessment in 2003, she was diagnosed with Klippel-Trénaunay syndrome due to a nevus flammeus vascular malformation on the left leg with well-defined limits, along with varicose veins inside that gave it an erythematous violaceous tone, all accompanied by noticeable elongation of that limb (Figures 1 and 2). She later required neurological assessment for instability and vertigo lasting several months. The neurological examination revealed Romberg’s sign with falling toward the right and unstable gait when walking. Imaging revealed descent of the cerebellar tonsils into the foramen magnum consistent with type I ArnoldChiari malformation (Figure 3). In neurological disorders, KlippelTrénaunay syndrome and ArnoldChiari malformation are rarely found together. We found only 1 published case in the literature reviewed (MEDLINE1966-2007).7 The low prevalence of both processes makes it somewhat unlikely for such an association to be incidental and, therefore, we believe it is important To the Editor: