# A Case Report of Dental Management of Patient With Arnold Chiari I Malformation

## TL;DR

This case report describes dental treatment for a patient with Arnold Chiari I Malformation, highlighting specific considerations for managing such patients.

## Contribution

The report presents the first documented case of Arnold Chiari I Malformation at Umm Al-Qura University Dental Teaching Hospital.

## Key findings

- Arnold Chiari I Malformation involves cerebellar tonsil herniation and can cause various neurological symptoms.
- Dental treatment for CM1 patients requires avoiding neck hyperextension and managing metal appliances for MRI compatibility.
- A tailored dental treatment plan was successfully implemented for the patient's specific needs.

## Abstract

Arnold Chiari malformation (CM) is a neurological disorder marked by the downward displacement of the cerebellar tonsils through the foramen magnum into the spinal canal, impacting the brain's posterior fossa, often associated with myelomeningocele, a form of spina bifida where the spinal cord protrudes through a spinal defect. Diagnosis is commonly made using MRI, with surgical intervention sometimes needed to relieve pressure on the brain and spinal cord. There are six types of CMs; Type I (CM1) is the most prevalent and is often identified in adulthood. CM1 involves herniation of the cerebellar tonsils through the foramen magnum, potentially causing symptoms such as headaches exacerbated by coughing, neck pain, dizziness, and sensory disturbances. Severe cases may include dysphagia, motor control issues, and sleep apnea. In dental treatment, CM patients should avoid prolonged neck hyperextension, which can increase discomfort, and metal appliances may need removal before MRI imaging. This case report documents the first case of CM1 at Umm Al-Qura University Dental Teaching Hospital and describes a tailored dental treatment plan designed to address the patient's specific needs.