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Old 05-29-2012
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Neuro confusion between type 1 and 2 chiari malformation

hydrocephalus is present in both type 1 and 2 chiari malformation????

or

it accompanies only type 2 chiari malformation.......??????

can someone post here all features of both type 1 and 2 chiari malformations or any thread link related to this ????
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waiting.......
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Quote:
Originally Posted by K06100 View Post
waiting.......

hi, this is what i know

Chiari 1: herniation of cerebellar tonsils into foramen magnum. Usu presents in adult, may be assymptomatic in infants.

Chiari 2: presents in neonatal period.

both i think have herniation however i is more likely to present with headache and ataxia and in adults.


please i have a question: theres this uworld question that describes a 17 yo girl who presents with trembling, extreme nervousness and feeling of passing out upon giving an oral presentation in class and she is now unwilling to present in her class and her grades are suffering, the question ask what meds to use.
uworld says the answer is propanolol and says she has specific phobia, my question is doesnt this girl have a social phobia and so shouldnt the treatment be SSRI?

thanks
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Quote:
Originally Posted by nativedoc2 View Post
hi, this is what i know

Chiari 1: herniation of cerebellar tonsils into foramen magnum. Usu presents in adult, may be assymptomatic in infants.

Chiari 2: presents in neonatal period.

both i think have herniation however i is more likely to present with headache and ataxia and in adults.

my doubt's still not clear......
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Quote:
Originally Posted by nativedoc2 View Post

please i have a question: theres this uworld question that describes a 17 yo girl who presents with trembling, extreme nervousness and feeling of passing out upon giving an oral presentation in class and she is now unwilling to present in her class and her grades are suffering, the question ask what meds to use.
uworld says the answer is propanolol and says she has specific phobia, my question is doesnt this girl have a social phobia and so shouldnt the treatment be SSRI?

thanks
for the ques u posted--both SSRI's and Beta blockers can be used....this is what I found at wikipedia-

''Some people with a form of social phobia called performance phobia have been helped by beta-blockers, which are more commonly used to control high blood pressure. Taken in low doses, they control the physical manifestation of anxiety and can be taken before a public performance.''

so answer can beta blockers too......for more u can search the web......!!
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my doubt's still not clear......

okay, type 11 is more likely to be asso with lumbar meningocele and syringomyelia

type 1 may be acquired in patients with hereditary dx of connective tissue.

thank you for answering my question!
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Quote:
Originally Posted by nativedoc2 View Post
okay, type 11 is more likely to be asso with lumbar meningocele and syringomyelia

type 1 may be acquired in patients with hereditary dx of connective tissue.

thank you for answering my question!

ur welcome.....

these things about type 2 i know

actually i only want to know the association of hydrocephalus with chiari malformation.......

don't worry i will figure it out
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if asked to guess i'll say that you expect hydrocep in type 11 the type assoc with babies, you expect an adults sutures to be closed and thus hydrocep is less likey.

i know this question seems silly but how tthen do i know when to answer ssri or propanolol for a social phobia. infact uworld said the lady had a specific phobia, how is that possible. the question id is 2502(377576)
thanks
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[QUOTE=nativedoc2;122493

i know this question seems silly but how tthen do i know when to answer ssri or propanolol for a social phobia. infact uworld said the lady had a specific phobia, how is that possible. the question id is 2502(377576)
thanks[/QUOTE]


I have seen FA step 1 ...it says SSRI's......if SSRI's r not in option,select beta blockers and vice-versa......

and if both r given in option, remember GOD,pray and select one which u find convenient.......
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Originally Posted by nativedoc2 View Post
if asked to guess i'll say that you expect hydrocep in type 11 the type assoc with babies, you expect an adults sutures to be closed and thus hydrocep is less likey.

for this , m going with what kaplan says.....type 1-no hydrocephalus
type 2-hydrocephalus.....
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ARNOLD-CHIARI malformation

Quote:
Chiari type I malformation is the most common and the least severe of the spectrum, often diagnosed in adulthood. Its hallmark is caudal displacement of peglike cerebellar tonsils below the level of the foramen magnum, a phenomenon variably referred to as congenital tonsillar herniation, tonsillar ectopia, or tonsillar descent. The resultant impaction of the foramen magnum, compression of the cervicomedullary junction by the ectopic tonsils, and interruption of normal flow of cerebrospinal fluid (CSF) through the region produce the clinical syndrome.
http://www.ninds.nih.gov/disorders/c...ail_chiari.htm

Quote:
Hydrocephalus is an excessive buildup of CSF in the brain. A CM can block the normal flow of this fluid, resulting in pressure within the head that can cause mental defects and/or an enlarged or misshapen skull. Severe hydrocephalus, if left untreated, can be fatal. The disorder can occur with any type of CM, but is most commonly associated with Type II.
Chiari Malformation

Quote:
Type II – In this condition, part of the back of the brain shifts downward through the bottom of the skull area.
Type II Chiari malformations are typically seen in infants who are born with spina bifida, a neurological condition that causes a portion of the spinal cord and the surrounding structures to develop outside, instead of inside, the body.
Type II Chiari malformations can also be associated with a condition known as hydrocephalus. Hydrocephalus is a condition in which there is an overproduction or lack of absorption of the cerebral spinal fluid (CSF) that is found inside of the ventricles (fluid-filled areas) inside of the brain. The increased fluid causes the pressure inside of the head to increase and the skull bones to expand to a larger-than-normal appearance.

Last edited by Novobiocin; 05-30-2012 at 07:09 PM.
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Quote:
Originally Posted by Novobiocin View Post
ARNOLD-CHIARI malformation



TYPE 1
due to downward diplacement of cerebellar tonsils

location foramen magnum

presentation
hydrocephlus all four ventricles dilated, macrocephaly, asymptomatic

TYPE 2
due to
parts of hindbrain, cerebral vermis, 4th ventricle (aqueductal stenosis)

location foramen magnum

associated with memingomyelocele (thoracolumbar)

presentation
brain stem dysfunction, stidor , poor swallowing, Syringomyelia

it means kalpan is wrong ?????pg 227...KLN-pediatrics

thanx for sharing........
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Originally Posted by K06100 View Post
it means kalpan is wrong ?????pg 227...KLN-pediatrics

thanx for sharing........
No, I was wrong.

Kaplan is right.

Read the links as above.

Thanks for posting this question, I would have never clarified this fact on my own.
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Originally Posted by Novobiocin View Post
No, I was wrong.

Kaplan is right.

Read the links as above.

Thanks for posting this question, I would have never clarified this fact on my own.
ok......ur welcum....

so kalpan is right......lets now memorize it......
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