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=== Chiari I malformation === {{Main article|page_name=Chiari malformation}}A Chiari malformation (CM) is a structural defect of the base of the skull and the cerebellum, characterized by a downward displacement of one or both cerebellar tonsils through the foramen magnum (the opening at the base of the skull). This can sometimes lead to non-communicating [[hydrocephalus]] as a result of obstruction of [[cerebrospinal fluid]] (CSF) outflow. While many clinical criteria consider Chiari malformation to be a differential diagnosis, a Swedish study of 234 ME/CFS patients meeting the [[Canadian Consensus Criteria]] found that a substantial proportion of patients had signs on their brain MRIs suggestive of intracranial hypertension: 55% had increased diameter of the optic nerve sheath. In addition 80% had cerebellar tonsillar descent that could potentially cause disruptions to spinal fluid flow, and thus increased intracranial pressure. 13.2% had tonsillar herniations severe enough to be considered a Chiari Malformation.<ref>{{Cite journal|url= https://www.frontiersin.org/articles/10.3389/fneur.2020.00828/full|access-date=2020-12-17 | title = Signs of Intracranial Hypertension, Hypermobility, and Craniocervical Obstructions in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = Aug 28, 2020 | last = Bertilson | first=Bragee | author-link = | last2 = Fahlgren | first2 = Michos | first3=Brandon | last3 = Drum | first4 = Robert | last4 = Szulkin | first5 = Bo C | last5 = Bertilson | authorlink2 = |archive-url=|doi=10.3389/fneur.2020.00828|journal=Front. Neurol.|volume =11 | page = 828|archive-date=|url-status=}}</ref>
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