Chiari Malformation is a type of structural defect involving the cerebellum, the part of the brain that controls balance. The cerebellum and parts of the brainstem sit in an indented space at the lower rear of the skull, above the foramen magnum (a funnel-like opening at the base of the skull leading to the spinal canal, through which the brainstem connects to the spinal cord). Normally, only the spinal cord passes through the foramen magnum, but in Chiari malformations, the lower part of the cerebellum extends downwards and into the foramen magnum.
Chiari Malformations may develop when the bony space where the cerebellum is housed is smaller than normal, causing the cerebellum and brainstem to be pushed downward into the foramen magnum and into the upper spinal canal. The resulting pressure on the cerebellum and brainstem may affect functions controlled by these areas and block the flow of cerebrospinal fluid (CSF) — the clear liquid that surrounds and cushions the brain and spinal cord — to and from the brain.
Chiari Malformation Symptoms
Patients often are asymptomatic and may not know they have the condition. If symptoms develop, they can include:
- Headache made worse by coughing, sneezing, straining, or bending the neck backwards
- Neck pain
- Weakness, especially grasp in one hand
- Numbness or other abnormal feelings in the arms or legs
- Loss of pain and temperature sensation
- Gait and balance problems
- Spasticity in the legs
- Vision problems
- Difficulty swallowing
- Ringing or buzzing in the ears
- Hand coordination and fine motor skill impairment
To determine whether you have a Chiari Malformation, your doctor may order a magnetic resonance imaging (MRI) scan. Treatment options vary. For patients who are asymptomatic surgery may not be needed. For those with significant symptoms, surgery is required to provide more space for the cerebellum and halt the progression of damage to the central nervous system. Unfortunately, there are no medicines that can correct Chiari malformation.
Chiari Malformation Treatment Center
Chiari Malformation Surgery involves making an incision at the back of the head and removing a small portion of the bottom of the skull around the foramen magnum, thus creating more space for the lower cerebellum. Often, surgery also requires laminectomy of the first portion of the cervical spine, where part of the arched bony roof of the spinal canal (the lamina) is removed. The chiari malformation surgeon also will make an incision in the dura (the covering of the brain) to examine the brain and spinal cord. Additional tissue may be added to the dura to create more space for the cerebellum and allow normal flow of cerebrospinal fluid.
Chiari Malformation Surgery Success Rate
Chiari malformation surgery generally has a high success rate. Although it is a major brain surgery, complication rates are low. With successful surgery, patients are usually cured for life from our surgeons.
Chiari Specialists in Texas
Contact our Houston Neurosurgeons if you are seeking Chiari malformation surgeons advice or treatment – (281) 313-0031. This disease requires a careful consultation and our neurosurgeons are experienced and qualified to help you find the best treatment option.