Korean Journal of Family Medicine

"Arnold-Chiari Malformation"

Case Reports

Chiari malformation type I with extensive syringomyelia presenting as progressive bilateral foot drop: a case report: Siti Anisah Jamaludin, Suraya Abdul-Razak, Shalini Bhaskar, Mimi Nashra, Nik Munirah Nik Mohd Nasir, Nordini Asri; Korean J Fam Med 2025;46(5):369-372. Published online April 11, 2025; DOI: https://doi.org/10.4082/kjfm.25.0020

Abstract
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Chiari malformation type I (CMI) is a structural abnormality characterized by cerebellar tonsil herniation through the foramen magnum, often leading to disrupted cerebrospinal fluid dynamics and syringomyelia. While CMI commonly presents with occipital headaches and neck pain, atypical manifestations, such as bilateral foot drops, are exceedingly rare. We describe a 37-year-old female patient presenting with bilateral foot drop, which was later established to be caused by syringomyelia secondary to CMI. Magnetic resonance imaging revealed an 8 mm tonsillar descent and a syrinx extending to the conus medullaris. The patient refused surgical intervention and opted for conservative management; partial functional recovery was subsequently observed. This report emphasizes the importance of recognizing rare neurological presentations of CMI. To our knowledge, this is the first documented case of CMI with syringomyelia presenting as a bilateral foot drop.

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A Case of a Girl with Arnold-Chiari Type 1 Malformation with Precocious Puberty: Min Sun Kim, Pyoung Han Hwang, Dae-Yeol Lee; Korean J Fam Med 2018;39(1):54-56. Published online January 23, 2018; DOI: https://doi.org/10.4082/kjfm.2018.39.1.54

Abstract
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A small percentage of individuals have the neurological anomaly of central precocious puberty (CPP). Common neurologic causes of CPP include a tumor or congenital lesions. Although Arnold-Chiari malformation can be caused by congenital or acquired causes, it is unusual in patients with CPP. We present the case of a girl aged 4.5 years who complained of breast budding. Her neurological examination and growth pattern were normal. She had no endocrinological abnormality, except for true precocious puberty. We performed brain magnetic resonance imaging, which showed an Arnold-Chiari type 1 malformation. Currently, this case represents the youngest girl who exhibited both Arnold-Chiari type 1 malformation and precocious puberty. Furthermore, it is likely that there is a meaningful association between the brain lesion and precocious puberty in this case.

Citations

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