Chiari Malformation

Chiari malformation (CM) can be quite scary for those who experience it. Thankfully, many cases can be successfully treated, and some cases don’t require treatment at all. Check out the below information to learn more about this condition.

What is Chiari Malformation? 

Chiari malformation is a structural defect in which brain tissue reaches into the spinal canal. Normally, the cerebellum (the part of the brain that controls balance) and parts of the brainstem sit in an indented space at the base of the skull. When these tissues extend past this space, it is known as a chiari malformation.

CMs can be present at birth or develop later in life as a result of injury or infection. There are four types of CM:

  • CM1 – This is the most common type. It involves only the cerebellum (not the brainstem) and can be acquired in adolescence or adulthood.
  • CM2 – Also known as classic CM or Arnold-Chiari malformation, this type involves tissues from both the brainstem and the cerebellum and is usually accompanied by myelomeningocele — a form of spina bifida that occurs when the spinal canal and backbone do not close before birth.
  • CM3 – Serious neurological defects may accompany this type of CM, which involves displacement of several forms of brain matter.
  • CM4 – This rare type involves an incomplete or underdeveloped cerebellum, which is known as cerebellar hypoplasia, and the lower cerebellum is located further down the spinal canal.

What are the Symptoms of Chiari Malformation?

People with CM1 often don’t experience any noticeable symptoms and may not even be aware of their conditions. However, symptoms can become more noticeable later in life, and may include:

  • Neck pain
  • Balance problems
  • Dizziness
  • Muscle weakness
  • Numbness in the arms or legs
  • Ringing or buzzing in the ears
  • Difficulty swallowing
  • Vomiting
  • Insomnia
  • Hearing loss
  • Depression
  • Headache that worsens with coughing or sneezing
  • Reduced hand coordination and motor skills

Scoliosis may also accompany this type of chiari malformation.

In babies, chiari malformation symptoms may include:

  • Irritability during feeding
  • Excessive drooling
  • Difficulty swallowing
  • Arm weakness
  • Stiff neck
  • Weak cry
  • Gagging or vomiting
  • Inability to gain weight
  • Developmental delays

How is Chiari Malformation Diagnosed?

If you are concerned that you may have CM, your doctor will examine your back, review your medical history, and may order diagnostic testing such as X-ray imaging, a bone scan, CT scan, myelogram, or an MRI to rule out other possible causes of your symptoms.

How is Chiari Malformation Treated?

Your best course of CM treatment will vary according to what type you have and what symptoms you are experiencing. Conservative treatments such as medication may be effective in alleviating your symptoms, or surgery may be necessary to correct defects that are affecting the spinal cord and harming your quality of life.

Two of the most common surgeries used to treat chiari malformation include:

  • Decompression surgery to create more space for the cerebellum and relieve pressure on the spinal column.
  • Spinal laminectomy to increase the size of the spinal canal and relieve pressure on the spinal cord and nerve roots.

The decision to undergo any type of surgery requires careful consideration and plenty of discussions with your doctor, who will be able to detail the benefits and potential risks of surgical treatment. If you have any questions about your condition and suggested course of treatment, never be afraid to ask!

Florida Medical Orthopaedics, Sports Medicine & Spine is proud to serve families in Tampa and Wesley Chapel, Florida.

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