3 CASES OF HINDBRAIN HERNIATION IN ADULTS WITH COMMENTS ON SOME DIAGNOSTIC DIFFICULTIES

In discussing the clinical features and surgical treatment of adult pa tients with Arnold Chiari deformity type I the authors focus on the di fferential diagnosis from demyelinating disease and present three illu strative cases. Our of 118 patients initially diagnosed as having demy elinating disease and admitted to our hospital between December 1991 a nd April 1993, three were subsequently found to have the Arnold Chiari deformity on MRI. The delay until correct diagnosis amounted to 10, 1 6 and 32 years, respectively. Our study stresses the diagnostic import ance of MRI of the craniocervical area in cases of unexplained neurolo gical symptoms and external signs of dysplasia. Accurate examination, early diagnosis and selection of proper surgical management can allevi ate severe symptoms in many instances and prevent neurological complic ations.