What is Chiari Malformation?
Chiari (Kee-Ar-ee) Malformation is a condition in which the lower portion of the brain (the cerebellar tonsils) descends into the upper cervical (neck) region. This can lead to pressure on the brain and spinal cord, resulting in a variety of symptoms.
Learn more about Chiari malformations.
What are the most common symptoms of Chiari malformation?
This condition can present in numerous ways because it affects the brain, spinal cord, and related structures. Symptoms vary based on the type (e.g., Chiari I, II, III), severity, and whether other associated conditions are present.
- Headache, particularly precipitated by coughing, straining, sneezing, etc. (valsalva maneuver)
- Balance problems, which may impair walking
- Dizziness
- Eye symptoms, most commonly to-and-fro movements of the eyes, called nystagmus
- Change in quality of the voice
- Swallowing problems
- Sleep disturbances
Learn more about Chiari symptoms.
What is Syringomyelia?
Syringomyelia (sear-IN-go-my-EEL-ya)
is a chronic spinal disorder in which cerebrospinal fluid enters the spinal cord, forming a cavity known as a syrinx. The syrinx can grow over time and damage the spinal cord, which can cause a variety of symptoms.
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What are the most common symptoms of Syringomyelia?
- Motor – Muscle weakness, Increased muscle tone (stiffness or spasticity), abnormal curvature of the spine (scoliosis)
- Sensory – Decreased feeling in hands and arms, exaggerated sensation (hypersensitivity) in limbs
- Pain – Midline pain over the spine, burning pain in arms, over trunk and rarely, legs, Joint pain, particularly in shoulders
Learn more about the symptoms of syringomyelia.
How are Chiari & Syringomyelia Diagnosed?
The most definitive way to diagnose Chiari malformation (MC) and syringomyelia (SM) is through imaging studies, particularly magnetic resonance imaging (MRI). The diagnoses CM/SM have become more frequent, in part due to the improvements in brain and spine imaging by MRI.
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How are Chiari & Syringomyelia Treated?
Patients with Chiari Malformation who do not require surgery are treated with a variety of therapies. These can include medications such as analgesics, anti-inflammatories, sedatives, anticonvulsants, antispasmotics, diuretics, and steroids. Evaluation by a neurologist to evaluate for other neurological disorders is important. Physical therapy may be of help in some patients and evaluation by a chronic pain specialist can also be helpful.
It is more or less recognized that the operative procedure for CM and SM is a posterior fossa (back of skull) craniotomy (opening) with possible removal of the upper-most portion of C1 (cervical laminectomy of the first cervical vertebra). The aim of the operation is to return the cerebrospinal fluid (CSF) circulation to as close to normal as possible.
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