Coexistence of Pseudotumor Cerebri and Chiari Malformation Type 1

Abstract

Objective: To identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1. Method: Patients who were clinically suspected to have Chiari malformation type 1 and were referred to the Department of Radiology between 2007 and 2020, and whose diagnosis was radiologically confirmed through magnetic resonance imaging (MRI), were retrospectively evaluated. A total of 49 Chiari malformation type 1 patients with both cervical and cerebral examinations and 49 control subjects of the same age and gender without a diagnosis of Chiari malformation type 1 were included in the study. In Chiari malformation type 1 diagnosed patients, the presence of pseudotumor cerebri, the presence of syringomyelia in cervical spinal MRI images, and the distance of cerebellar tonsils and obex according to McRae line were evaluated in millimeters. Result: In Chiari malformation type 1 clinically and radiologically diagnosed cases, the cerebellar tonsils and obex were located lower in patients with a radiological diagnosis of pseudotumor cerebri compared to those without, and the rate of accompanying syringomyelia appeared to be higher. However, no statistically significant difference was observed between the two groups. Conclusion: The coexistence of pseudotumor cerebri and Chiari malformation type 1 is more common than previously estimated. Different treatment protocols in the coexistence of pseudotumor cerebri and Chiari malformation type 1 emphasize the importance of making this diagnosis. Further radiological imaging studies are needed to identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1.