Can Chiari 1 Malformations be Causally Related to Trauma

Imagine suffering from daily headaches, painful tension in neck, dizziness, fatigue, vision problems, balance issues, pressure and pain in neck, ringing in ears and many other symptoms.  In individuals that have tonsillar descent, pressure can be put on the brainstem and result in many of the above referenced symptoms and much more serious ones that could result in the need for immediate surgical intervention.  As a brain injury attorney, I understand the significance of this injury that is often ignored by many practitioners.

Chiari 1 Malformation is also known as a herniation of the cerebellar tonsils.  In a normal brain and neck there is enough room around the base of the brain to allow Cerebral Spinal Fluid (CSP) to flow in and out of the area without problem.  In a problematic neck that does not allow enough room for this fluid to flow effectively the cerebellar tonsils are forced downward down past the foramen magnum.  This becomes very dangerous and sprouts many of the symptoms discussed.

CSP surrounds not only the brain but the spinal cord as well.  The body is designed to allow CSP to flow freely throughout the brain and spinal cord to protect arguably the two most important segments of the body.  Unfortunately, when the flow is interrupted it could build up and form Syringomyelia, or a Syrinx.  A syrinx (forced buildup of spinal fluid inside the spinal cord) is extremely dangerous and will likely result in surgery to alleviate this condition.

The question becomes when and how did this malformation start or occur.  Assuming that the tonsilar herniation was present throughout an individual’s life then the question is, “If an otherwise symptom free individual goes their entire life without having manifested a known symptom of Chiari 1, and then is involved in a motor vehicle accident that caused an onslaught of symptoms, isn’t it likely that the onset of symptoms was caused by trauma? New reports and studies point in the affirmative.

As a Florida brain injury attorney, I have seen a number of Chiari 1 malformation cases and have become accustomed to the typical arguments propounded by the defense. Insurance adjusters and defense lawyers alike will point to the abundance of medical literature that suggests a Chiari 1 malformation is congenitive in nature.  However, several recent studies indicate that Chiari 1 malformations can be exacerbated and aggravated by trauma.  Further, there are many well documents instances of injury victims who were symptom free until a traumatic incident resulted in Chiari 1 related issues.  This lends credence to the belief that Chiari 1 can lie dormant for years until a traumatic incident such as a car wreck results in an asymptomatic condition becoming symptomatic.

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