Dr Batzdorfs letter re trama association

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this is an electronic copy of Dr Batzdorfs letter to me ...he send a paper

copy too , lol .

hope this helps ..

June 30, 2000

To Whom It May Concern:

Re: J. Bates

UCLA #082-66-12

Ms. Bates has been under my neurosurgical care for treatment of a Chiari

Malformation. I first saw her on May 12, 1998, at which time she described

some sensory symptoms dating back to 1987 and related to her coexisting

multiple sclerosis. However, in December 1996 she was involved in a motor

vehicle accident in which she sustained a " whiplash " type of injury. Within

weeks she developed dizziness, headache and visual changes, as well as

increased weakness of her left leg; she had two episodes of impaired

consciousness and dizziness with neck extension. She required

hospitalization. An MR scan showed 5 mm of tonsillar descent, which

increased to 8 mm of descent by December 1997, with MR evidence of

diminished CSF flow around the cerebellar tonsils. When seen by me she also

spoke of strain-related headaches, which were progressive in severity.

Review of her MR scans showed evidence of progressive molding and impaction

of the cerebellar tonsils between February 1, 1997 and December 1997, as

evidenced by a change in configuration of the tonsils from rounded to

somewhat pointed, and additional descent of the tonsils by approximately 3

mm.

Based on the known association of trauma as the initiating event that leads

approximately 24% of patients with Chiari Malformation to become symptomatic

and seek medical help, I believe there is a reasonable medical certainty

that the injury Ms. Bates sustained in December 1996 caused her Chiari

Malformation (presumed to have been present to some degree prior to the

accident) to worsen to the point of becoming symptomatic and then

progressive and for new symptoms characteristic of Chiari Malformation. such

as headache and dizziness on neck extension, to develop. Thus, there is

reasonable medical certainty that the accident caused aggravation of a

pre-existing condition.

Ulrich Batzdorf, M.D.

Professor of Neurosurgery

Director of Spine Surgery

UB:mbl

J. Bates

1318 Garnet Lane

Paradise, CA 95969

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Date: Fri, 30 Jun 2000 14:11:41 -0700

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