Delirium, headache, and the type I Arnold-Chiari malformation.

نویسندگان

L E Mehl

J Astill

چکیده

Acute delirium can occur in a variety of states including migraine, l head trauma,2 nonconvulsive status epilepticus,3 and cerebral infarction.4 Acute delirium accompanied by migrainous headache is much more common in children than adults and is termed acute confusional migraine.s In 1883 John Cleland, a British poet and anatomist, first described the abnormality of the brainstem and cerebellum now called the ArnoldChiari malformation (ACM).6 Chiari in 1891and Arnold in 1894 further detailed this anomaly in children. Students of Arnold coined the term Arnold-Chiari malformation in 1907. In type I ACM, the cerebellum extends downward through the foramen magnum. Associated abnormalities can include hydrocephalus and syringomyelia or cavitation within the spinal cord. Type II ACM is characterized by all the features of type I plus elongation of the fourth ventricle into the spinal canal, displacement of the medulla, and crowding of the cervical cord roots into an upward course. Severe hydrocephalus and myelomeningocele are usually apparent. The focus of this review will be the type I malfonnation. Misdiagnosis of ACM is common because of the vague nature of the symptoms and the variable course of the disease. The vague and bizarre symptoms might initially suggest a psychiatric disorder.1 The incidence, although not precisely known, is considered to be between 1 and 2 per 1000 births.8 We present a case report of a woman with acute delirium, migrainous-like headache, and the type I Arnold-Chiari malformation.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Arnold-Chiari Type II Malformation: A Case Report and Review of Prenatal Sonographic Findings

The Arnold-Chiari malformation is a congenital abnormality of CNS, characterized by downward displacement the parts of the cerebellum, fourth ventricle, pons and medulla oblongata into the spinal canal. This malformation is one of causative factor of death in neonates and infants. A thorough understanding of the direct and indirect sonographic findings is necessary for diagnosis of Chiari II ma...

متن کامل

Chiari type I malformation, syncope, headache, hypoglycemia and hepatic steatosis in an 8-year old girl: a causal association?

Chiari type I malformation (CMI) is a congenital hindbrain anomaly characterized by downward displacement of the cerebellar tonsils through the foramen magnum. Chiari type I malformation often presents with a complex clinical picture and can be sporadic or linked to a variety of genetic conditions. We report on a girl in whom Chiari type I malformation was associated with hypoglycemia, headache...

متن کامل

Arnold Chiari I Malformation with Tip-Toe Gait: A Case Report

The Arnold-Chiari type I malformation has many symptoms such as headache, neck pain, gait impairment, abnormal movements or postures. But a few cases reported association of specific symptom including headache, neck pain, vertigo or ataxia. We report a case of 12 year-old boy presenting with tip-toe gait. Magnetic resonance imaging (MRI) study of brain and spine revealed underlying Arnold-Chiar...

متن کامل

Chiari Malformation Type I Presenting as Cluster-like Headache.

PURPOSE Although different types of headache have been described in Chiari malformation type I, reports of cluster-like headaches are rare. CASE REPORT We report a 26-year-old man who presented with a two-week history of excruciating headache in the right temporal region after coughing, which was accompanied by autonomic features including right-sided nasal congestion and tearing from his rig...

متن کامل