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Chiari Malformations 03

Topic: Adult

Created on Friday, May 30 2008 by jdmiles

Last modified on Friday, May 30 2008.


An adult patient presents to your clinic. Because of symptoms he describes, you obtain the MRI shown above.
Which of the following symptoms were most likely among this patient's complaints?

 
        A) Miosis
 
        B) Being eaten by a bear
 
        C) Headaches, predominantly in the occiput and neck
 
        D) Generalized tonic-clonic seizures
 
        E) Hemiparesis
 

 


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This question was created on May 30, 2008 by jdmiles.
This question was last modified on May 30, 2008.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Miosis

This answer is incorrect.


This MRI shows a Chiari malformation. Miosis is not a common presenting symptom of a Chiari malformation.  (See References)

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B) Being eaten by a bear

This answer is incorrect.


This MRI shows a Chiari malformation. Being eaten by a bear is not a common presenting symptom of a Chiari malformation.  (See References)

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C) Headaches, predominantly in the occiput and neck

This answer is correct.


This MRI shows a Chiari malformation. Suboccipital headaches are a common presenting complaint.  (See References)

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D) Generalized tonic-clonic seizures

This answer is incorrect.


This MRI shows a Chiari malformation. While seizures and Chiari could certainly coexist, the presence of generalized seizures is not typical or suggestive of a Chiari malformation.  (See References)

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E) Hemiparesis

This answer is incorrect.


This MRI shows a Chiari malformation. Hemiparesis is not a common presenting symptom for a Chiari.  (See References)

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References:

1. Sklar, E.M.L., Ruiz, A., Quencer, R.M., and Falcone, S.F. (2004). Structural neuroimaging. In Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.). Neurology in Clinical Practice, Fourth Edition. Butterworth Heinemann, Philadelphia, pp. 521-597 (ISBN:0750674695). Advertising:
2. Sarnat, H.B., and Flores-Sarnat, L. (2004). Developmental disorders of the nervous system. In Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.). Neurology in Clinical Practice, Fourth Edition. Butterworth Heinemann, Philadelphia, pp. 1763-1789 (ISBN:0750674695). Advertising:
3. Rosenbaum, R.B., and Ciaverella, D.P. (2004). Disorders of bones, joints, ligaments, and meninges. In Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.). Neurology in Clinical Practice, Fourth Edition. Butterworth Heinemann, Philadelphia, pp. 2189-2222 (ISBN:0750674695). Advertising:
4. Robert I. Grossman, David M. Yousem. Neuroradiology: the requisites. Philadelphia, Pa. : Mosby, c2003. (ISBN:032300508X) Advertising:
5. Floyd, T. (1999). "Bear-inflicted human injury and fatality." Wilderness Environ Med, 10(2) 75-87. (PMID:10442155)
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adult
Chiari Malformations 03
Question ID: 053008023
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 05/30/2008
Modified: 05/30/2008
Estimated Permutations: 943800
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