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Chiari Malformation: Sudden Onset of Symptoms After Trauma

The Arnold Chiari I Malformation is an often mis-understood condition in which the lowest lying portion of the brain; the cerebellar tonsils, are forced out of the normal place inside the skull. As a result, this part of the brain often compresses portions of the afflicted person’s brainstem and upper spinal cord. In other words, a Chiari malformation is a structural defect of the cerebellum; the part of the brain responsible for controlling your balance.

A Chiari Malformation occurs when the cerebellum dips into the spinal canal known as the foramen magnum.
Chiari Malformation is sometimes referred to as tonsillar ectopia or herniation because of the area of the brain that is displaced, are generally considered to be congenital (from birth) defects that begin to cause symptoms once the sufferer reaches adulthood.

The questions about Chiari Malformations surround whether they are causally related to head or neck trauma. The consensus is that trauma, even minor head trauma or whiplash, can cause aggravation, or even the onset of painful symptoms associated with a Chiari Malformation.

Chiari Malformation Symptoms

Chiari symptoms include:

  • Severe headaches
  • Dizziness and vertigo
  • Vision problems
  • Clumsiness
  • Spastic movements of the limbs
  • Neurological problems such as numbness or weakness in the extremities

We do not dispute the fact that a Chiari Malformation is a congenital disorder. However, several recent studies indicate that trauma (such as a car accident) can make an otherwise asymptomatic condition symptomatic [see reference].

Studies Related to Chiari Malformation

Several studies have suggested that a previously undetected Chiari I malformation can be symptomatically awakened as a result of trauma caused during a motor vehicle crash. While these studies determined that head or neck trauma is capable of “triggering” symptoms relating to Chiari I malformations, in a 2010 study, Michael D. Freeman and number of other experts set out to determine an even more intriguing question: could motor vehicle crash trauma actually be the sole cause of a Chiari I malformation? The answer is that it’s definitely possible.

The theory is that those suffering from a Chiari have an underdeveloped cranial cavity making the individual predisposed to an exacerbation or aggravation of this pre-existing issue [see ref]. Trauma can force the cerebellum deeper into the foramen magnum. As a result, an asymptomatic Chiari can suddenly become symptomatic as a result of the accident [see ref]. Please check out this study on Chiari. http://www.welcomebackcentre.com/files/documents/6.pdf

Chiari and Auto Accidents

Many times auto accident victims begin to experience the above referenced symptoms, only to find out that they have been afflicted with a Chiari Malformation since long before the trauma. A Chiari Malformation is generally diagnosed with a standard MRI scan after the onset of symptoms. The symptoms are often chronic, meaning that they persist for an extended amount of time (usually six to twelve months from date of onset). Unfortunately, those afflicted to Chiari Malformation-related symptoms have very few treatment options available. Decompression surgery is used in a very small number of cases involving extremely severe pain or neurological problems. Chiari can greatly impede the flow of cerebrospinal fluid resulting in a buildup of such in the brain. This can interfere with normal brain functions and affect a number of bodily controls.

Fortunately, in Florida, individuals experiencing Chiari-related symptoms, which only began to manifest after a trauma, have recourse. Despite the fact that the condition is considered congenital, the symptoms can be attributed to (even minor) head or neck trauma. Florida acknowledges an accident victim’s right to recover for exacerbation or aggravation of a pre-existing injury. This means that when a victim of negligence can sufficiently prove that the symptoms were spurred by the traumatic event, Florida courts will allow that victim to recover for the medical care and suffering that they incur.

Are My Chiari Symptoms Caused by a Car Accident?

Some criteria that will be considered in evaluating whether your symptoms are being caused by the accident include:

  • Whether the victim was asymptomatic prior to the traumatic event.
  • Whether the trauma resulted in significant injuries to the head or neck.
  • How long after the trauma the Chiari-related symptoms manifested (within six (6) months).
  • Whether another pre-existing condition could be causing the symptoms.

Chiari Malformations Images

The following Chiari Malformation photos represent where and how the bulge forms.

Chiari Malformation: Sudden Onset of Symptoms After Trauma

Chiari Malformation Pictures

Diagnosing Chiari

Discovering the existence of a Chiari I Malformation is not a reason to despair. If your congenital problem has been aggravated by somebody else’s negligence, seek counsel of a knowledgeable attorney with experience handling cases involving your condition. A Chiari Malformation should not be ignored and a consultation with a Neurosurgeon is always recommended wherein the physician can review the MRI film and correlate such with your clinical presentation. Unfortunately, many physicians ignore the presence of Chiari Malformations believing such not to be a serious condition and based on outdated science which labels this as a congenital condition only.

In our personal injury practice, we have brought a number of health care professionals up to speed on the recent studies indicating that an asymptomatic Chiari Malformation can become symptomatic as a result of trauma. Insurance carriers utilize outdated science when faced with a claimant suffering from symptomatic Chiari. We often litigate such cases as the applicable insurance carrier fails to properly evaluate claims involving Chiari in a pre-lawsuit context. Thus, such cases become heavily laden in expert testimony. In order to properly litigate a Chiari case, a great number of resources must be expended including the retention of a Radiologist along with a Neurosurgeon to present and explain this issue to a jury.

We have been trusted to handle a number of cases involving Chiari Malformations for fellow attorneys and we pride ourselves in taking up the cause for individuals who have been turned away because the root of their symptoms is congenital. Find justice at Sibley Dolman Gipe Accident Injury Lawyers, PA today.

Freeman MD, Rosa S, Harshfield D, Smith F, Bennett R, Centeno CJ, Kornel E, Nystrom A, Heffez D, Kohles SS. A case-control study of cerebellar tonsillar ectopia and head/neck (whiplash) trauma. Brain Injury 2010;24(7-8):988-94.

J Neurosurg 1995 Sep;83(3):556-558 Acquired Chiari malformation and syrin associated with bilateral chronic subdural hematoma. Case report. Morioka T, Sho Nishio S, Yoshida K, Hasuo K, Fukui M. Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, Speer MC. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1999 May;44(5):1005-17.

Image credits: (1) Wikimedia:BasketofPuppies;(2) Wikimedia:Hellerhoff;(3) Wikimedia:Raymond F Sekula Jr, Peter J Jannetta, Kenneth F Casey, Edward M Marchan, L Kathleen Sekula and Christine S McCrady;(4) Wikimedia:Ravin