What clinical feature is commonly associated with Chiari malformation in pediatric patients?

Chiari malformation, particularly type I, is often associated with chronic headaches in pediatric patients. These headaches are typically characterized as having a cervicogenic pattern, often worsening with activities that increase intracranial pressure, such as coughing or straining. The headaches can also be accompanied by symptoms related to changes in cerebrospinal fluid flow or compression of surrounding structures in the brain.

As the condition involves a herniation of the cerebellar tonsils through the foramen magnum, it can create tension and irritation of the structures in the posterior fossa, leading to neurological complaints that manifest predominantly as chronic headaches. Other associated symptoms may include neck pain, balance issues, or sensory disturbances, but chronic headaches remain one of the most prominent features observed in clinical presentations.

The other options, while they may occasionally be present in some patients, are not as commonly linked to Chiari malformation as chronic headaches. Seizures are more indicative of other neurological disorders, while behavioral problems and visual disturbances may arise from different mechanisms not directly tied to the hallmark features of Chiari malformation.