Chiari Malformations (CMs)
CMs are structural defects in the cerebellum, the part of the brain that controls balance. CMs can be caused by genetic malfunctions, lack of nutrients or other complications before birth. CMs can also be caused by injury, infection or exposure to harmful substances.
CMs can cause symptoms such as headache and neck pain, numb arms or legs, problems with balance, dizziness, vision, swallowing, muscle weakness, ringing ears and hearing loss, vomiting, insomnia, depression. Hand coordination and fine motor skills may also be affected. Sometimes there are no symptoms and CMs are only found during other tests or treatments.
Diagnosis and Treatment Options
To diagnose CM, Dr Tollesson will evaluate your medical history, signs and symptoms, and do a physical and neurological examination. He will perform a number of neurological examinations in conjunction with Diagnostic Radiology such as, computed tomography (CT) or magnetic resonance imaging (MRI) to determine diagnosis and a treatment plan.
In some cases, a brain and spinal cord examination might require an incision in the covering of the brain.
Surgery might be needed to correct CMs and avoid further damage to the central nervous system. Current procedures include:
- Posterior fossa decompression surgery involves an incision at the back of the head to remove a small portion of the bottom of the skull (and sometimes part of the spinal column). High-frequency electrical currents can be used to target CMs.
- Spinal laminectomy involves removing part of the bony part of the spinal canal (the lamina) to relieve pressure on the spinal cord and nerve roots.
Surgery for CMs takes around three hours with recovery in hospital for three to five days. Due to the position of the spine during surgery, patients sometimes experience headache and neck pain after surgery. This can be treated with pain medication.