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t m c ยป p u l s e | n o v e m b e r 2 0 1 6 12 Mind Over Matter A young student at McGovern Medical School navigates a serious brain condition B y A l e x a n d r a B e c k e r A t the time, Claudia Martinez considered the accident to be minor, miraculous even. Not only were the passengers in both cars unharmed, but the cyclist, whose bike lay crumpled under her car, had managed to throw himself off to the side of the road in the split-second before impact. That was supposed to be the end of the story, but a short while later, Martinez began suffering from nearly constant headaches. Piercing and dull at the same time, the pain was soon accompanied by tremors in her hands and lower limbs similar to those observed in patients with Parkinson's disease. One day, her small frame buckled to the floor after she'd tried to stand up and couldn't feel her legs. It was 2011, and Martinez did not have time to be sick. A diligent student, she was engrossed in pre-med course- work at the University of Houston, her days consumed with organic chemistry, violin practice, research, volunteering and shadowing physicians. So when an MRI revealed a neurological condition called Chiari malformation, Martinez confronted the diagnosis with her char- acteristic tenacity. "I remember when I first met with the neurosurgeon, I said, 'I'm not here to just be cured, I'm here to get well enough to live out my life doing what I love,'" Martinez recalled on a recent morning at home. Parked next to her at the breakfast table was a wheelchair she was learning to live without. Using the handles to steady herself, Martinez, 25, was once again walking after undergoing her fifth brain surgery in as many years. Chiari malformation occurs when the cerebellum, which sits above the spine and coordinates and regulates muscular activity, extends lower than it should, spreading into the cervical spinal canal and compressing the brain- stem. Some individuals with the con- dition are completely asymptomatic, while others experience mild to severe headaches and motor and sensory problems. And while nobody knows for certain whether the jolt from the crash triggered Martinez's condition, Chiari malformation, which is generally considered to be congenital, may also be acquired later in life. Claudia Martinez studying at home in her bedroom.