Chiari Type I Malformation Presenting with Unilateral Hearing Loss.

Introduction:  Chiari type I malformations can present in different ways, but the most frequent symptom is an occipitocervical headache. Hearing loss as the main presenting symptom is rare.

Case:  A young woman with progressive left-sided unilateral hearing loss was diagnosed with a Chiari type I malformation.

Delayed orbital fibrosing inflammation from a retained crayon.

A 39-year-old woman presented with sudden onset of double vision, right upper eyelid swelling and ptosis, and orbital pain. Imaging revealed an irregular mass of the upper right orbit with central non-enhancing areas. Upon inquiry, the patient recalled an intraorbital trauma with a crayon in her childhood, 35 years ago.