A patient with an Arnold Chiari I malformation may experience sudden death. Fortunately, the occurrence of sport-related complications is low.

Risk factors for sudden death in a patient with Chiari Type I malformation include:

(1) head trauma (even seemingly mild)

(2) an increase in intracranial pressure


In general, participation in most sports should be safe for a patient with Chiari I malformations.


Reasons for caution:

(1) risk for severe head or neck trauma: football, soccer (heading), boxing/martial arts

(2) symptomatic status (vs asymptomatic)

(3) opioid analgesics for pain (can cause respiratory depression)


Additional concerns:

(1) return to play decisions

(2) management after concussion


A patient who has had foramen magnum decompression would be at lower risk for herniation.

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