Chiari Malformations (CMs)

Chiari malformations (CMs) are structural abnormalities affecting the cerebellum, the part of the brain responsible for balance and co-ordination. They are usually present at birth and may result from abnormal brain and skull development during foetal growth. In some cases, they may be associated with genetic factors. Acquired Chiari malformations can also occur as a result of injury, infection, or other medical conditions.

Symptoms

CMs can cause a range of symptoms, including headaches, neck pain, numbness or tingling in the arms and legs, balance problems, dizziness, visual disturbances, swallowing difficulties, muscle weakness, ringing in the ears (tinnitus), hearing loss, nausea and vomiting, insomnia, and depression. Hand co-ordination and fine motor skills may also be affected. In some cases, there may be no symptoms, and the condition is discovered incidentally during investigations for another medical problem.

Diagnosis and Treatment Options

To diagnose a Chiari malformation, Dr Tollesson will review your medical history, assess your signs and symptoms, and perform a physical and neurological examination. Diagnostic imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI), are commonly used to confirm the diagnosis and assist in developing an appropriate treatment plan.

In some cases, additional investigations of the brain and spinal cord may be required to assess the extent of the condition and its effects on the nervous system.

Surgery may be recommended to relieve pressure on the brain and spinal cord, restore normal cerebrospinal fluid flow, and prevent further neurological damage. Current surgical procedures include:

• Posterior Fossa Decompression Posterior fossa decompression surgery involves making an incision at the back of the head and removing a small section of bone from the base of the skull. In some cases, a portion of the upper cervical spine may also be removed to create additional space and reduce pressure on the brain and spinal cord.

• Spinal Laminectomy A spinal laminectomy involves removing part of the vertebral bone (the lamina) to relieve pressure on the spinal cord and nerve roots.

Recovery

Surgery for a Chiari malformation typically takes around three hours, with a hospital stay of approximately three to five days. Due to positioning during surgery and the nature of the procedure, some patients may experience headaches and neck pain during recovery. These symptoms can usually be managed effectively with pain medication. Recovery times vary depending on the individual and the extent of the surgery performed.