Trauma May Aggravate Chiari 1 Malformation, Tethered Cord Syndrome
Spinal cord injuries (SCIs) and traumatic brain injuries (TBIs) may aggravate pre-existing conditions, turning them from asymptomatic to symptomatic in some cases. Two common examples are Chiari malformation type 1 and Tethered Cord Syndrome (TCS).
What Is Chiari 1 Malformation?
Chiari malformation type 1 is a condition in which the cerebellar tonsils are displaced out of the skull into the spinal cord area. In other words, the part of the brain at the back of the skull bulges through the opening where the skull and spinal canal meet.
This condition is normally congenital. Although rare, according to Johns Hopkins, acquired or secondary Chiari 1 malformation may develop later in life.
Studies have shown that trauma to the neck or head, such as whiplash, can cause pre-existing Chiari 1 malformation to turn symptomatic. For example, a 2008 study found that minor neck or head trauma turned asymptomatic Chiari 1 to symptomatic Chiari 1 in about 1 in 4 patients who experienced trauma prior to the onset of their symptoms.
Common symptoms of Chiari 1 malformation include:
- Headaches, especially after sneezing, coughing, or straining
- Balance problems or an unsteady gait
- Neck pain
- Poor hand-eye coordination
- Numbness in the hands and feet
- Trouble speaking and swallowing
- Breathing problems, such as sleep apnea
- Ringing in the ears, or tinnitus
- Slowed heart rhythm
A significant number of Chiari 1 patients also have Tethered Cord Syndrome, so much so that some surgeons routinely evaluate Chiari 1 patients for TCS.
What Is Tethered Cord Syndrome?
Tethered Cord Syndrome is a condition in which the spinal cord is abnormally tethered or anchored, thereby pulling the spine and causing leg weakness and neurological problems.
Although TCS is congenital, studies have shown that concussions or whiplash injuries to the neck and spine may aggravate the pre-existing condition. A history of spine trauma may also lead to the development of TCS.
The longer TCS remains undiagnosed, the worse the strain on the spinal cord may become. This may lead to the deterioration of sensory and motor functions, as well as poor bladder control (incontinence).
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