Presentation and Outcomes in Chiari I Malformation: Patient-Centered Interpretation of Clinical Research

David D. Limbrick Jr., MD, PhD presented at Virginia Commonwealth University on “Presentation and Outcomes in Chiari I Malformation: Patient-Centered Interpretation of Clinical Research”. Dr. Limbrick begins with the simple, textbook definitions and “classic presentations” of Chiari and syringomyelia such as: Chiari-type headache, fainting, visual changes, speech difficulties in Chiari and sensory loss/weakness, myelopathy, and scoliosis in syringomyelia. However, he explains that that these defintiions and “classic presentations” are not so much the norm these days. Limbrick also touches on alternative designations including: Chiari 1.5, Chiari 0, Chiari 0.5. He then moves on to discuss a few patient-centered research projects, papers, groups, and tools developed to measure the success of treatment of Chiari and syringomyelia. Some of these are: Park Reeves Syringomyelia Research Consortium, in which Dr. Limbrick was directly involved, The Chiari Health Index for Pediatrics (CHIP) out of Vanderbilt, and papers considering instability, scoliosis, reducing rate of complications with surgical intervention, the genetics of the disease, and more! He also looks towards the future, asking: Can we improve our outcome measures? Are they relevant to quality of life? What is Chiari I malformation anyway and can we redefine CM-1 using contemporary analytics? This lecture was given at the Virginia Commonwealth University in Richmond, VA on February 15th. (2024)