Rossettini Giacomo, Maselli Filippo, de Filippis Cosimo, Mourad Firas, Lovato Andrea
Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova, Savona, ITA.
Sovrintendenza Sanitaria Regionale Puglia, Direzione Regionale Puglia INAIL, Bari, ITA.
Cureus. 2021 Feb 22;13(2):e13482. doi: 10.7759/cureus.13482.
CrossFit workout is associated with injuries mostly located over the spine and upper limb. Chiari I malformation (CIM) is characterized by migration of the cerebellar tonsils below the foramen magnum and this clinical condition has never been described after high-intense training such as CrossFit. A 19-year-old woman presented to the ED with acute vertigo, nausea, vomiting, and horizontal spontaneous nystagmus; symptoms began after an intense workout session. During neuro-otological examination, spontaneous positional left-beating horizontal nystagmus, normal response to bi-thermal caloric stimulations, and unremarkable cervical vestibular evoked myogenic potentials in both ears were observed; pure tone audiometry showed normal hearing. Central vertigo was suspected; therefore, an MRI was done, which identified a CIM. The patient's symptoms spontaneously improved at short term. The six-month follow-up MRI confirmed no changes. The subject completely stopped any training and remained asymptomatic over a 12-month follow-up. Our case report is the first describing CIM presented with acute vertigo after a high-intensity training.
CrossFit训练与主要位于脊柱和上肢的损伤有关。Chiari I型畸形（CIM）的特征是小脑扁桃体向枕骨大孔下方移位，而这种临床情况从未在CrossFit等高强度训练后被描述过。一名19岁女性因急性眩晕、恶心、呕吐和水平性自发性眼球震颤就诊于急诊科；症状在一次高强度训练后开始出现。在神经耳科检查中，观察到自发性位置性向左跳动的水平性眼球震颤、对双温冷热试验刺激的正常反应以及双耳正常的颈前庭诱发肌源性电位；纯音听力测定显示听力正常。怀疑为中枢性眩晕；因此，进行了MRI检查，结果发现了CIM。患者的症状在短期内自发改善。六个月后的随访MRI证实没有变化。该受试者完全停止了任何训练，在12个月的随访中一直无症状。我们的病例报告是首例描述高强度训练后出现急性眩晕的CIM病例。
