Type I CHIARI Malformation in a High School Football Player Kannapolis City Schools Sports Medicine Type I CHIARI Malformation in a High School Football Player Grady J. Hardeman, M.Ed., LAT, ATC

Kannapolis City Schools Sports Medicine Case History 14 year old male high school defensive lineman. MOI: Direct force to the head from a team mate while attempting to make a tackle during a junior varsity football game. Athlete denies any previous injuries or symptoms prior to this injury.

Kannapolis City Schools Sports Medicine Initial Evaluation Athlete denied any symptoms. (I feel fine) Approximately 30 seconds later the athlete reported a headache and feeling like he was “out of it”. Exhibited post impact memory deficits. Cranial Nerve Assessment checked out normal.

A.M. Follow Up Evaluation Kannapolis City Schools Sports Medicine A.M. Follow Up Evaluation Athlete still presented with mild post concussion symptoms the following morning. Headache Photophobia Concentration Difficulties Athlete was referred to the primary care sports medicine physician for follow up evaluation. Cranial Nerves Assessed and findings were normal. Athlete was monitored daily until he saw the physician.

Kannapolis City Schools Sports Medicine Physician Evaluation Confirmed Concussion Ordered MRI due to continued symptoms. D/C all physical activities Decreased work load in classes. Placed on Shortened School Day. MRI Outcome

Kannapolis City Schools Sports Medicine Baseline

Kannapolis City Schools Sports Medicine Post Injury #1

Kannapolis City Schools Sports Medicine Post Injury #2

Kannapolis City Schools Sports Medicine Post-Injury #3

Kannapolis City Schools Sports Medicine Post-Injury #4

Neurosurgical Referral Kannapolis City Schools Sports Medicine Neurosurgical Referral Pt was cleared from concussion 1 month post injury. After discussion with parents, consultation with Neurosurgery to talk about ramifications of the Chiari malformation Discuss risk in general Discuss risk with return to sports Contact vs. Collision

Initial Clinical Evaluation Kannapolis City Schools Sports Medicine Initial Clinical Evaluation

Initial Clinical Evaluation Kannapolis City Schools Sports Medicine Initial Clinical Evaluation

Initial Clinical Evaluation Kannapolis City Schools Sports Medicine Initial Clinical Evaluation

Initial Clinical Evaluation Kannapolis City Schools Sports Medicine Initial Clinical Evaluation

Initial Clinical Evaluation Kannapolis City Schools Sports Medicine Initial Clinical Evaluation

Initial Clinical Evaluation Kannapolis City Schools Sports Medicine Initial Clinical Evaluation

Initial Clinical Evaluation Kannapolis City Schools Sports Medicine Initial Clinical Evaluation

Initial Clinical Evaluation Kannapolis City Schools Sports Medicine Initial Clinical Evaluation

Kannapolis City Schools Sports Medicine Outcome “We Treat Our Students as People First and Athletes Second”