When symptoms are present, they usually do not appear until adolescence or early adulthood, but can occasionally be seen in young children. The majority of patients complain of severe head and neck pain. Headaches are often accentuated by coughing, sneezing or straining. Patients may complain of dizziness, vertigo, disequilibrium, muscle weakness or balance problems. Often fine motor skills and hand coordination will be affected.
Vision problems can also occur.
Some patients experience blurred or double vision, difficulty in tracking objects or a hypersensitivity to bright lights. Patients may have difficulty swallowing, frequent gagging and choking and, in some cases, sleep apnea may be present. Syringomyelia is a disorder in which cerebrospinal fluid enters the spinal cord, forming a cavity known as a syrinx. It is recommended that patients diagnosed with a Chiari Malformation have the entire spine imaged to rule out the presence of a syrinx, since it may be a consideration in treatment and prognosis. Surgical procedures to enlarge the posterior fossa are considered a treatment option for patients with the Chiari I Malformation.