Type I CHIARI Malformation in a High School Football Player

Grady J. Hardeman, M.Ed., LAT, ATC

Type I CHIARI Malformation in a High School Football Player

Kannapolis City Schools Sports Medicine

Case History14 year old male

high school defensive lineman.

MOI: Direct force to the head from a team mate while attempting to make a tackle during a junior varsity football game.

Athlete denies any previous injuries or symptoms prior to this injury.

Kannapolis City Schools Sports Medicine

Kannapolis City Schools Sports Medicine

Initial EvaluationAthlete denied any

symptoms. (I feel fine)

Approximately 30 seconds later the athlete reported a headache and feeling like he was “out of it”.

Exhibited post impact memory deficits.

Cranial Nerve Assessment checked out normal.

Kannapolis City Schools Sports Medicine

A.M. Follow Up EvaluationAthlete still presented with mild post

concussion symptoms the following morning.HeadachePhotophobiaConcentration Difficulties

Athlete was referred to the primary care sports medicine physician for follow up evaluation.

Kannapolis City Schools Sports Medicine

Physician EvaluationConfirmed

ConcussionOrdered MRI due to

continued symptoms.

D/C all physical activities

Decreased work load in classes.

Placed on Shortened School Day.

MRI Outcome

BaselineKannapolis City Schools Sports Medicine

Post Injury #1Kannapolis City Schools Sports Medicine

Post Injury #2Kannapolis City Schools Sports Medicine

Post-Injury #3Kannapolis City Schools Sports Medicine

Post-Injury #4Kannapolis City Schools Sports Medicine

Kannapolis City Schools Sports Medicine

Neurosurgical ReferralPt was cleared from concussion 1 month post injury.

After discussion with parents, consultation with Neurosurgery to talk about ramifications of the Chiari malformation

Discuss risk in generalDiscuss risk with return to sports

Contact vs. Collision

Kannapolis City Schools Sports Medicine

Initial Clinical Evaluation

Kannapolis City Schools Sports Medicine

Initial Clinical Evaluation

Kannapolis City Schools Sports Medicine

Initial Clinical Evaluation

Kannapolis City Schools Sports Medicine

Initial Clinical Evaluation

Kannapolis City Schools Sports Medicine

Initial Clinical Evaluation

Kannapolis City Schools Sports Medicine

Initial Clinical Evaluation

Kannapolis City Schools Sports Medicine

Initial Clinical Evaluation

Kannapolis City Schools Sports Medicine

Initial Clinical Evaluation

OutcomeKannapolis City Schools Sports Medicine

“We Treat Our Students as People First and Athletes Second”