Chiari Malformation

Chiari MalformationAt American Neurospine Institute, PLLC, we are here for our patients diagnosed with Chiari Malformation.

What is a Chiari Malformation?

A Chiari Malformation is a condition when brain tissue extends into the spinal canal. This condition is often considered a congenital condition as it is present at birth and often caused by under-development, leaving the skull either too small or misshapen and pressing down on the brain pushing tissue through a small natural opening and into the upper spinal canal. This added pressure interferes with the flow of cerebrospinal fluid which can block signals from being transmitted properly from the brain to the body or create a buildup of fluid within the brain and spinal cord affecting the central nervous system and causing neurological impairments.

There are several types of Chiari Malformations and are determined by the severity of the condition:

  • Type I-This is the first stage and most common type of Chiari Malformation. In most cases, it is due to the base of the skull and upper spinal canal not being formed properly. It is often unnoticed until problems arise in early childhood or adolescence.
  • Type II- Type II is less common and occurs when the brain stem begins to shift down through the bottom of the skull. This type of Chiari Malformation is commonly associated with another condition, Hydrocephalus, where there is an overproduction or lack of absorption of cerebrospinal fluid inside the brain.
  • Type III- Type III Chiari Malformation occurs when a larger portion of the brain protrudes out the opening of the skull and into the spinal canal. This type is very rare and can cause severe neurological disability.
  • Type IV- Type IV is extremely rare and is diagnosed when the back of the brain fails to develop properly. In many cases, the cerebellum is underdeveloped, or larger parts of the cerebellum are not formed.

Symptoms

Symptoms will vary depending on the severity of the condition and individual patient. Some may not appear until childhood, adolescence, or early adulthood. Common symptoms may include:

  • Breathing problems
  • Depression
  • Difficulty swallowing or speaking
  • Difficulty with balance
  • Dizziness
  • Headaches
  • Hearing problems
  • Insomnia
  • Loss of sensation
  • Muscle weakness
  • Neck pain
  • Problem with hand-eye coordination and fine motor skills
  • Rapid Eye Movement
  • Scoliosis
  • Sleep Apnea
  • Vomiting

Diagnosis

In some cases, if other disorders or defects are present at birth, the diagnosis may be made at birth. However, in most cases, the diagnosis is not made until after specific signs and symptoms are examined and diagnostic tests such as MRIs and CT scans confirm a Chiari Malformation.

Treatment

If the patient does not show any symptoms or if the condition does not interfere with daily life, the doctor may only need to monitor the condition regularly with diagnostic imaging. For more mild symptoms, medication may be prescribed to ease headaches and offer pain relief.

However, for more progressive conditions, surgery is the recommended treatment option to help remove symptoms and halt the progression of damage to the central nervous system. The most common surgery used to treat Chiari Malformation is known as a posterior fossa decompression surgery. During this procedure, space is made for the brain by removing a small portion of the skull to alleviate pressure and restore the normal flow of cerebrospinal fluid. Your doctor may also remove some of your spinal column to allow for more space.

During your consultation, your doctor will inform you of the risks and chances of success for surgery so you can determine what the best treatment option is for you. The risks associated with treatment include the possibility of infection, fluid in the brain, cerebrospinal fluid leakage, or improper healing. It is important to note that if nerve damage has already occurred within the spinal canal, treatment cannot reverse this damage.

It can take several months to recover from surgery with several days spent in the hospital for monitoring and care. Headaches and neck pain are common during recovery but should subside after several weeks. For more information on Chiari Malformations and how we can help you or to schedule an appointment, contact American Neurospine Institute, PLLC today at (972)806-1188.

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