Chiari Malformation

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Chiari malformations(CMs) are a group of complex brain abnormalities that affect the area in lower posterior skull where the brain and spinal cord connect. The underlying anatomy of Chiari malformations is thought to be present at birth (congenital), although in many cases they may not become clinically apparent until adulthood.This malformation is of five types.

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Sign and Symptoms

 CMs can cause headaches, difficulty swallowing, vomiting, dizziness, neck pain, unsteady gait, poor hand coordination, numbness and tingling of the hands and feet, and speech problems.Findings are due to brain stem and lower cranial nerve dysfunction. Onset of symptoms are less likely to be present during adulthood in most patients. Younger children generally have a substantially different presentation of clinical symptoms from older children. The blockage of cerebrospinal fluid (CSF) flow may also cause a syrinx to form, eventually leading to syringomyelia. Syringomyelia is a chronic progressive degenerative disorder characterized by a fluid-filled cyst located in the spinal cord. Its symptoms include pain, weakness, numbness, and stiffness in the back, shoulders, arms or legs.

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Diagnosis

By clinical examination and imaging as CT and MRI brain.

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Treatment

Depending upon the type of CM and symptoms of the patient surgery in needed. Depending upon the severity of the condition decompression surgery is done which involved removal of the posterior part of the skull and vertebrae(Posterior fossa decompression). Shunt is done if hydrocephalus if present.

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