Upright MRI in Ehlers Danlos Syndrome, Chiari Malformation, and Craniocervical Instability (CCI)

Upright MRI in Ehlers-Danlos Syndrome, Chiari Malformation, and Craniocervical Instability (CCI)

A Living Signal Research Evidence-Based Doctor Handout

Traditional supine MRI can miss crucial findings in patients with Ehlers Danlos Syndrome (EDS), dysautonomia, and Chiari related conditions. This handout compiles peer-reviewed evidence explaining why upright or flexion extension MRI may reveal critical diagnostic information that standard imaging overlooks.

Designed for both patients and clinicians, this educational summary translates complex research into clear, accessible language that can be shared directly with providers to support informed discussions and improve documentation accuracy.

This 7 page PDF distills findings from over ten peer-reviewed studies, including Fluids and Barriers of the CNS, World Neurosurgery, and Acta Neurochirurgica, highlighting how posture, connective-tissue laxity, and CSF flow dynamics influence MRI results and clinical interpretation.

Inside This Handout

• Gravity-Dependent Imaging Differences – How upright posture alters CSF velocity, intracranial pressure, and venous return compared with supine MRI.
• Connective-Tissue Laxity and Dynamic Instability – Evidence that ligamentous laxity in EDS allows measurable translation at the clivo-axial junction only visible under gravitational load.
• CSF Flow and Autonomic Correlation – How dynamic obstruction at the foramen magnum contributes to dysautonomia, headaches, and brainstem related symptoms.
• Venous Outflow and Compliance – Why jugular vein collapse and posture related venous shifts can change intracranial compliance and symptom expression.
• Symptom Correlation and Functional Impact – Linking upright MRI findings with real world symptoms such as headache, vertigo, visual pressure, and POTS related flares.
• Key Literature Summary – Ten fully cited references from 2006–2024 across neurosurgical, imaging, and autonomic medicine journals.

Who It’s For

• Patients with EDS, POTS, or Chiari symptoms seeking to communicate their concerns effectively to medical providers.
• Physicians, radiologists, and neurosurgeons evaluating dynamic or connective tissue related instability.
• Advocates, caregivers, and researchers coordinating multidisciplinary care and diagnostic referrals.

Format

• 7 page printable PDF (8.5×11″)
• Professionally formatted and citation-supported
• Ideal for neurology, neurosurgery, or autonomic consults
• Designed to support collaborative doctor-patient dialogue and accurate record documentation