Neurosurgical pathologies represented the most common underlying disorders with Arnold-Chiari malformation in four and ganglioglioma in three patients.

The authors report a case of symptomatic basilar impression and Arnold-Chiari malformation being presented as the first symptom of hemifacial spasm.

The vast majority of these patients present with a Chiari malformation type I.

There was also a pseudo- Chiari malformation type I with ectopia of the cerebellar tonsil.

Before that, Holmes had brain surgery in 2011 after being diagnosed with Chiari malformation.

Brain magnetic resonance imaging revealed that the patient also had non-communicating hydrocephalus with Chiari malformation.

Chiari malformations are a diverse group of abnormalities of the brain, craniovertebral junction, and the spine.