Azarkar Ghodsiyeh, Nemati Sahar, Vafadar Shabnam, Sharifzade Gholam Reza, Ziaee Arash, Ashrafi Hossein
Infectious Diseases Research Center, Birjand University of Medical Sciences, IR.
Department of audiology, razi Hospital, Birjand University of Medical Sciences, Birjand, IR.
J Belg Soc Radiol. 2023 Oct 3;107(1):80. doi: 10.5334/jbsr.3264. eCollection 2023.
Chiari malformation exhibits well-defined clinical signs, symptoms, and incidence rates in clinical studies. However, cerebellar tonsil ectopia presents with ambiguous symptoms and undetermined incidence rates in numerous studies. Our objective was to determine the incidence of cerebellar tonsil ectopia in individuals with headaches and identify additional clinical symptoms. This aims to improve diagnosis accuracy for clinicians and neurologists, leading to more effective treatment approaches.
A cross-sectional study conducted in 2022 included 2305 participants aged 4-78 years presenting with headache. Chiari malformation was diagnosed using magnetic resonance imaging (MRI) scans, with a definition of cerebellar tonsil herniation extending beyond 5mm into the cervical canal.
The prevalence of Chiari malformation was 3.4%, with no significant gender difference (p = 0.72). There was a significant correlation between Chiari malformation and headache exacerbation due to the Valsalva maneuver (p < 0.001) and the presence of vertigo (p < 0.001). No significant association was found between Chiari malformation and accompanying symptoms such as nausea (p = 0.43), photophobia (p = 0.2), phonophobia (p = 0.52), and speech disorders (p = 0.45).
These findings suggest a notable prevalence of Chiari malformation among headache patients and its association with specific headache characteristics, such as acute and occipital headaches, exacerbation by the Valsalva maneuver, and the co-occurrence of vertigo. These results underscore the need to consider Chiari malformation in the differential diagnosis of patients presenting with these specific headache features.
在临床研究中，Chiari畸形表现出明确的临床体征、症状和发病率。然而，在众多研究中，小脑扁桃体异位的症状不明确，发病率也不确定。我们的目的是确定头痛患者中小脑扁桃体异位的发病率，并识别其他临床症状。这旨在提高临床医生和神经科医生的诊断准确性，从而带来更有效的治疗方法。
2022年进行的一项横断面研究纳入了2305名年龄在4至78岁之间的头痛患者。使用磁共振成像（MRI）扫描诊断Chiari畸形，定义为小脑扁桃体疝入椎管超过5毫米。
Chiari畸形的患病率为3.4%，性别差异无统计学意义（p = 0.72）。Chiari畸形与Valsalva动作诱发的头痛加重（p < 0.001）和眩晕的存在（p < 0.001）之间存在显著相关性。未发现Chiari畸形与恶心（p = 0.43）、畏光（p = 0.2）、畏声（p = 0.52）和言语障碍（p = 0.45）等伴随症状之间存在显著关联。
这些发现表明Chiari畸形在头痛患者中具有较高的患病率，且与特定的头痛特征相关，如急性和枕部头痛、Valsalva动作诱发的加重以及眩晕的同时出现。这些结果强调在对具有这些特定头痛特征的患者进行鉴别诊断时需要考虑Chiari畸形。
