Chiari. Valsalva-aware.
The thing that makes Chiari Chiari is the trigger pattern: a cough, a sneeze, bending to tie a shoe, a laugh that lasts a beat too long. Leo's hub flags how many of your episodes are Valsalva-tagged and surfaces today's barometric pressure right next to it. Logged honestly, charted as observations, never sold as predictions.
Cerebellar tonsils sitting where they shouldn't.
Chiari malformation is a structural defect where the cerebellar tonsils extend below the foramen magnum into the spinal canal. Type I — the most common form — is often discovered incidentally on MRI and can stay quiet for decades, or it can produce a constellation of headaches, balance issues, swallowing problems, and neurologic symptoms. The hallmark trigger is anything that briefly raises intracranial pressure: a cough, a sneeze, a strain, bending forward. The Valsalva pattern.
Decompression surgery is one common path; many patients also live with Chiari long-term without operative intervention. Comorbidities are common — connective-tissue disorders (EDS), autonomic dysfunction (POTS), mast cell issues — and Leo ships separate hubs for those, so the Chiari hub doesn't try to do everything.
A card on your hub that tells you what percentage of your episodes are Valsalva-tagged.
When you log a flare, you tag the trigger. Leo's Valsalva card watches for seven trigger keywords that match the Valsalva pattern and shows you, across your recent episodes, how often they appear and which ones are most common.
Today's pressure, the 24-hour change, and a flag when it drops fast.
Atmospheric pressure swings are a commonly reported Chiari trigger. The hub's hero card pulls live weather for your location and shows three things at once: current pressure (hPa), 24-hour change with a direction arrow, and an orange banner when the absolute 24-hour change crosses 5 hPa. Every symptom log also captures the environmental snapshot in the background — pressure, temperature, humidity, weather condition, even UV index — so you can see what the weather was doing the moment any given episode hit.
Live reading in hPa, with a trend icon — rising, falling, steady, rapidly rising, rapidly falling.
How much pressure has changed in the last day. Direction and magnitude both shown.
Visible when the absolute change crosses 5 hPa. Not an alert — just a heads-up.
Sixteen Chiari-specific symptoms, three pre-filled flare types.
The Chiari pack pre-loads sixteen condition-specific symptoms so you're not scrolling a generic library to find “choking on liquids”:
Occipital headache · Neck pain / stiffness · Dizziness / vertigo · Balance problems · Numbness / tingling · Difficulty swallowing · Choking on food or liquids · Tinnitus · Vision disturbances · Nausea · Brain fog · Fatigue · Muscle weakness · Speech difficulty · Sleep apnea symptoms · Facial pain
Three episode templates start a flare-log with the right symptoms already ticked, so the field-work takes ten seconds in the middle of an actual episode:
Cough / sneeze / strain / laugh-triggered. Pre-fills occipital headache, neck pain, nausea, and dizziness.
Dizziness, numbness, balance, vision, brain fog — the neurologic-symptom cluster.
Bending over, position changes. Pre-fills occipital headache, dizziness, neck pain, nausea.
Six cards. Five labs pinned.
Open the hub and the dashboard is a single readable surface — barometric pressure at the top, your trends and Valsalva analysis below, the last five episodes at the bottom. Quick actions to log a new episode, log a Valsalva event, or open the calendar.
Current pressure, 24h trend, rapid-change flag, temperature, humidity.
Episode count, average severity, and days since last flare — all in one bento.
Splits the last 14 days into halves and labels you Worsening, Stable, or Improving with a ±0.5-point threshold.
% of recent episodes tagged with a Valsalva trigger, plus the top tags ranked by frequency.
Frequency-ranked breakdown of every trigger tag, Valsalva or otherwise.
Last five flares with date, severity, and trigger preview.
Labs pinned to the Chiari pack: CBC · CMP · Vitamin D · B12 / Folate · Inflammatory markers. Out-of-range values are flagged. Most are tracked because Chiari frequently coexists with conditions where these matter — your neurosurgeon or neurologist may add more.
The list of things we'd like to ship, and haven't yet.
The Chiari hub is one of the more deliberately scoped surfaces in Leo — Valsalva, barometric, symptoms, episodes, labs. The list below is what it doesn't do yet. Every item is on the feature-parity tracker, and the page updates as items ship.
Decompression date, duraplasty, hardware, surgeon, and post-op symptom comparison aren't yet a structured surface in the Chiari hub. Log surgeries in the general surgical-history view for now.
Cerebellar tonsil position (mm below the foramen magnum), syrinx presence, length, and location — these aren't yet structured fields. Coming.
Useful intracranial-pressure proxy. The current symptom set doesn't distinguish positional headache pattern beyond the Positional Episode template.
EDS, POTS, and MCAS are commonly co-occurring. Their hubs exist, but the Chiari hub doesn't yet inline-summarize them.
The 5 hPa rapid-change flag is fixed today. Some patients are sensitive to smaller swings; some need larger. Personalization is on the list.
Triggers are tagged after a flare. A first-class "perform-a-Valsalva, log how it went" surface — similar to FND's breathing-exercise log — isn't built.
Severity trend, Valsalva %, barometric overlay, episode log as one shareable document. Today exports go through the general Leo health report.
The Valsalva pattern, on the front page of your hub.
Valsalva-trigger detection, barometric pressure overlay, sixteen condition-specific symptoms, three pre-filled flare templates, five pinned labs, and a backlog we name out loud.