Investigation of the Disease Progression of Pediatric Patients with Incidental Chiari I Malformation

Grant Recipient: Kerri Thorn, PA-C, Children’s National Medical Center, Washington, DC

Purpose of the study: Some patients are found to have Chiari I malformation after they have an MRI scan of the head or neck to evaluate for another condition. The finding of Chiari I Malformation on the MRI study is considered to be “incidental Chiari I malformation,” which requires no treatment, if symptoms are thought to be unrelated to Chiari I Malformation. The fate of patients with incidental Chiari I malformation is uncertain. Research is required to answer these important questions: 1) What percentage of patients with incidental Chiari I malformation will later develop symptoms and require treatment for Chiari I malformation? 2) Can specific findings on MRI scans predict who will develop symptomatic Chiari I malformation? 3) Are there data to support routine follow-up MRI scanning in these patients?

Researchers at Children’s National Medical Center, Washington, DC, are performing a ten-year retrospective review of their database of patients with “incidental Chiari I malformation” and “symptomatic Chiari I malformation.” They will evaluate whether patients with the diagnosis of incidental Chiari I malformation developed symptomatic Chiari I malformation during that time period. The study will also compare symptoms and MRI findings of patients with incidental Chiari I malformation with those of patients with symptomatic Chiari I malformation and evaluate for factors that predict development of symptomatic Chiari I malformation. The project has already received Investigational Review Board (IRB) approval. Kerri Thorn, PA-C., is the Principal Investigator on the project and her Associated Investigators include a pediatric neurosurgeon and a physician assistant. An ASAP Grant has been awarded and research will start immediately.