1. 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

2. 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.

3. 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.

4. 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.

5. 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

6. Kannapolis City Schools Sports Medicine
Baseline

7. Kannapolis City Schools Sports Medicine
Post Injury #1

8. Kannapolis City Schools Sports Medicine
Post Injury #2

9. Kannapolis City Schools Sports Medicine
Post-Injury #3

10. Kannapolis City Schools Sports Medicine
Post-Injury #4

11. 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

12. Initial Clinical Evaluation
Kannapolis City Schools Sports Medicine
Initial Clinical Evaluation

13. Initial Clinical Evaluation
Kannapolis City Schools Sports Medicine
Initial Clinical Evaluation

14. Initial Clinical Evaluation
Kannapolis City Schools Sports Medicine
Initial Clinical Evaluation

15. Initial Clinical Evaluation
Kannapolis City Schools Sports Medicine
Initial Clinical Evaluation

16. Initial Clinical Evaluation
Kannapolis City Schools Sports Medicine
Initial Clinical Evaluation

17. Initial Clinical Evaluation
Kannapolis City Schools Sports Medicine
Initial Clinical Evaluation

18. Initial Clinical Evaluation
Kannapolis City Schools Sports Medicine
Initial Clinical Evaluation

19. Initial Clinical Evaluation
Kannapolis City Schools Sports Medicine
Initial Clinical Evaluation

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