Chiari Type I Malformation in a Child with Syringomyelia and Scoliosis: A case report

The association between pediatric Chiari malformation and the development of syringomyelia has been well documented. Scoliosis in the patient with syringomyelia is thought to be secondary to anterior horn cell damage, which innervate the muscles of trunk, by an asymmetrically expanded syrinx. In pediatric patients, the neurologic signs and symptoms due to Chiari malformation and syringomyelia show much lower frequency but the incidence of scoliosis is very high. Thus, the MRI study for the diagnosis of the underlying syringomyelia and Chiari malfornation is essential in pediatric scoliosis patients, which may otherwise be misdiagnosed for idiopathic scoliosis. We present a case of Chiari type I malformation associated with syringomyelia and scoliosis.

Brain MRI in children with delayed development: emphasis on white matter maturation

To analyzed the progression of white matter maturation and white matter pathology, MR imaging of the brain was obtained in 38 children with delayed development. Children with developmental delay showed a high incidence of MR abnormalities(34/38, 89.5%). Delayed pattern of myelination and gray-white matter differentiation was seen in 13 patients. Twenty-two patients had white matter patholgy, including 14 with white matter hypoplasia, seven with focal small infarction, five with periventricular leukomalacia, and three with high signal intensities on T2 weighted image. Associated structural abnormalities were also evaluated. The most common lesions in decreasing frequency were cerebral atrophy and dysgenesis of the corpus callosum, pachygyria and/or polymicrogyria, porencephalic cyst and Leigh's disease. Twenty-three of 34 children had multiple abnormalities on MRI. The MRI was useful in depicting the progression of myelination and other white matter lesions, and serial follow-up MR is recommended for patients with delayed or lack of myelination and gray-white matter differentiation.