The frequency of cerebellar tonsillar ectopia in primary headache patients

Dindayal, Saiesha Arti
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Background: The frequency of cerebellar tonsillar ectopia (TE) has not been adequately quantified in the headache population to date. Aims: To determine the frequency of TE (both borderline tonsillar ectopia [BTE] and Chiari 1 malformation (CM-1)) in patients with primary headache disorder. To compare the frequency of tonsillar ectopia to the estimated frequency reported in the general population. Methods: The records of 299 adult (≥18yrs) patients with primary headache and magnetic resonance images (MRI) of the brain were retrospectively reviewed and directly examined for the lowest cerebellar tonsillar position. Patients were stratified according to lowest tonsillar position into 3 groups; normal, BTE and CM-1. Secondary causes of tonsillar ectopia were excluded. Frequency tables were computed and reported. Results: Of the 299 patients with primary headache disorder there were, 14 BTE (4.7%) , 3 CM-1 (1%) and 282 (94.3%) normal category patients . The frequency of BTE in primary headache patients was 4.7% and is of statistical significance (p= 0.004) when compared to a neuroradiological series. The frequency of CM-1 in primary headache patients compared to that reported in the general population showed no significant difference between them (p>0.05)
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment for the degree of Master of Medicine in the division of Neurology Johannesburg 2019
Dindayal, Saiesha Arti (2019) The frequency of cerebellar tonsillar ectopia in primary headache patients, University of the Witwatersrand, Johannesburg, <>