Symptoms of Chiari Malformations

“When symptoms such as headaches, dizziness, and fatigue persist, they often rob a person of their quality of life. Though not everyone experiencing these symptoms is suffering from Chiari I Malformation, for those that are, we’re here to provide answers and options. We’re here to help.” – John Oró, MD Symptoms from the Chiari I malformation often develop in a slow and insidious manner. The symptoms are often vague and progress slowly over a number of years. Many patients have symptoms for years before they are diagnosed with the Chiari I Malformation. About 1 out of 4 patients develop symptoms after trauma. The trauma is often mild or moderate in nature. Patients have reported accidents such as a falling off a trampoline, falling off a porch, accidentally hitting the back of their head or falling while riding a bicycle.
The most common symptom of the Chiari I malformation is headache. The headache usually begins at the back of the head and radiates behind one or both eyes, the top of the head or the temples. The headache is often described as a pressure sensation but can be heavy, sharp, or stabbing. For many, the pain varies between these and other sensations.
The headache is often made worse by straining activities (known as valsalva maneuvers) such as coughing, sneezing, or even laughing or singing. Some patients report feeling as though “my head will explode” or like “my head will pop off”. Bending forward, or looking up can worsen the headache. When the headache is intense, some patients will note dizziness, blurring of vision, nausea, or a feeling of a “mental fog”.

Visual Symptoms

A variety of other visual symptoms can occur with the Chiari I malformation including double vision, decreased peripheral vision, seeing flickers of light (“fireflies”), visual loss, blind spots, photophobia, spasm of the eyelids (blepharospasm), and jerking of the eyes (Nystagmus).

Auditory Symptoms

Symptoms of the hearing and the balance system include dizziness, ringing in the ears (Tinnitus), poor balance (disequilibrium), decrease or loss of hearing, and vertigo. Other symptoms related to the Cranial nerves and their nuclei include hoarseness, problems swallowing (Dysphagia), slurring of words (dysarthria), and numbness of the face.

Extremity Symptoms

Many patients complain of weakness, numbness or tingling, or pain in the arms or legs. Often, only one side is involved.

Respiratory and Heart Symptoms

Effects of the Chiari malformation on the respiratory and heart centers can cause shortness of breath, chest pain, episodes of rapid heart rate (tachycardia), black out spells, and hypertension. Abdominal symptoms may include nausea, abdominal pain, or vomiting.

General Symptoms

These include depression, poor sleep (insomnia) and fatigue. Some note problems with memory, thinking and speech. People report the feeling of a “brain fog” with difficulty in thinking and concentration. Difficulty in finding the right word is not uncommon.
With so many possible symptoms, most which can be caused by other conditions, a physician may not suspect the Chiari malformation as a possible cause of the symptoms.
It is important to note that other conditions can result in symptoms similar to that of the Chiari I malformation.

Other conditions that should be considered include:

Migraine
Cluster headache
Rebound headache
Pseudotumor cerebri
Occipital neuralgia
Post-concussion syndrome
Hydrocephalus
Multiple sclerosis
Chronic fatigue syndrome
Fibromyalgia
Sleep apnea
Spinal fluid leak
Arachnoid cyst
Degenerative disc disease
Psychiatric disease