Caudal Traction as a Pathogenetic Mechanism of Chiari Malformation Type I

Abstract

Despite the important achievements made with respect to our understanding of their clinical and image features, Chiari malformations are the result of etiopathogenetic mechanisms still sunk into mystery, while most of the efforts to dissipate it are isolated attempts that deal with rather late, secondary pathogenetic events, such as the reduction of the posterior fossa volume, the crowdedness of its contents or the disturbances of the cerebrospinal fluid flow at the level of the foramen magnum. Nevertheless, until new research will shed light onto many of these processes, the actual partial, fragmented knowledge can be structured in a much more reliable manner if one holds the theory of caudal traction as a guiding principle. We present a potential pathogenesis that could culminate into an abnormal axial tension throughout the spinal cord, as well as some image and therapeutic features found during our clinical practice, testifying in favor of this relentless caudal traction.