Description

Chiari malformation (kee-AH-ree mal-for-MAY-shun) is a condition in which brain tissue extends into the spinal canal. Occurs when a part of the skull is deformed or smaller than usual. The skull presses on the brain and forces it down.

Chiari malformation is uncommon, but increased use of imaging tests has led to more diagnoses.

The professional of the health group of Chiari malformation into three types. The type depends on the anatomy of the tissues of the brain that is inserted into the spinal canal. The type also depends on if there are changes in the development of the brain or of the spinal column.

Chiari malformation type 1 develops as the skull and brain are growing. The symptoms do not occur until late childhood or adulthood. The pediatric forms of Chiari malformation are type 2 and type 3. These types are present at birth, which is known as congenital.

Treatment of Chiari malformation depends on the type and symptoms. Regular monitoring, medications, and surgery are the treatment options. Sometimes no treatment is needed.

Symptoms

Many people with Chiari malformation do not have symptoms and do not need treatment. They learn they have Chiari malformation, only when the tests are performed for unrelated conditions. But some types of Chiari malfunction can cause symptoms.

The most common types of Chiari malformation are:

  • Type 1
  • Type 2

These types are less severe than the more rare form of pediatric, type 3. But the symptoms can still interrupt the life.

Chiari malformation type 1

In the Chiari malformation type 1, symptoms usually appear during late childhood or adulthood.

Headaches are the classic symptom of Chiari malformation. They generally occur after sudden coughing, sneezing, or straining. People with Chiari malformation type 1 may also experience:

  • The neck pain.
  • Unsteady walk, and problems with balance.
  • Poor hand coordination.
  • Numbness and tingling of the hands and feet.
  • The dizziness.
  • Difficulty swallowing. This happens sometimes with nausea, choking, and vomiting.
  • Changes in speech, such as hoarseness.

Less often, people with Chiari malformation may experience:

  • Ringing or buzzing in the ears, known as tinnitus.
  • The weakness.
  • A slow heart rate.
  • The curvature of the spine, known as scoliosis. The curvature is related to spinal cord impairment.
  • Problems with breathing. This includes central sleep apnea, which is when a person stops breathing during sleep.

Chiari malformation type 2

In the Chiari malformation type 2, a greater amount of tissue that extends into the spinal canal compared with Chiari malformation type 1.

Symptoms may include those associated with a form of spina bifida called myelomeningocele. Chiari malformation type 2, it almost always comes with myelomeningocele. In myelomeningocele, the spinal column and the spinal canal do not close properly before birth.

Symptoms may include:

  • Changes in the breathing pattern.
  • Difficulty swallowing, such as nausea.
  • Rapid decline in eye movements.
  • Weakness in the arms.

Chiari malformation type 2 is usually noted on ultrasound during pregnancy. It can also be diagnosed after birth or in early childhood.

Chiari malformation type 3

Chiari malformation type 3 is the most severe type of the disease. A portion of the lower part of the brain known as the cerebellum, or brain stem extending through an opening in the skull. This form of Chiari malformation is diagnosed at birth or during the pregnancy with an ultrasound.

Chiari malformation type 3 causes of the brain and nervous system problems, and has a high rate of death.

When to see a doctor

Consult a health professional if you or your child has any of the symptoms that may be associated with a Chiari malformation.

Many of the symptoms of a Chiari malformation can also be caused by other conditions. A complete medical evaluation is important.

Causes

Chiari malformation type 1 occurs when part of the skull is too small or is deformed. This part of the skull that contains the area of the brain called the cerebellum. The skull puts pressure on the crowds and the brain. As a result, the lower part of the cerebellum known as the tonsils are pushed into the upper part of the spinal canal.

Chiari malformation type 2 is almost always associated with a form of spina bifida called myelomeningocele.

When the cerebellum is pushed towards the upper part of the spinal canal, which can interfere with the usual flow of cerebrospinal fluid that protects the brain and the spinal cord. The cerebrospinal fluid can build up in the brain or the spinal cord. Or it can cause the signals transmitted from the brain to the body to be blocked.

Also, the pressure of the cerebellum, the spinal cord or lower brainstem can cause symptoms.

Risk factors

There is No evidence that the Chiari malformation is run in some families. However, the investigation of a possible hereditary component is still in its early phase.

Complications

In some people, the Chiari malformation may not have symptoms and do not need treatment. In others, the Chiari malformation gets worse over time and leads to serious complications. Complications can include:

  • The hydrocephalus. Hydrocephalus occurs when excess fluid accumulates in the brain. This can cause problems with thinking. People with hydrocephalus may need a flexible tube called a shunt placed. The derivation is deflected and drains excess cerebrospinal fluid to a different area of the body.
  • Spina bifida. Spina bifida is a condition in which the spinal cord or its cover is not fully developed. Part of the spinal cord is exposed, which can cause serious diseases such as paralysis. People with Chiari malformation type 2 usually have a form of spina bifida called myelomeningocele.
  • Syringomyelia. Some people with Chiari malformation will also develop a condition called syringomyelia. In people with this condition, a cavity or a cyst, called a syrinx, forms within the spinal column. As the syrinx grows, it can press on the nerves and cause pain, weakness, and stiffness.
  • The tethered cord syndrome. In this condition, the spinal cord connects to the spine and causes the spinal cord to stretch. This can cause serious nerve and muscle damage in the lower part of the body.

Diagnosis

To diagnose Chiari malformation, your health care professional to review your medical history and symptoms and do a physical exam.

Imaging tests can help diagnose the condition and determine its cause. Tests may include:

  • Magnetic resonance imaging (MRI).AnMRIis often used for the diagnosis of Chiari malformation. AnMRIuses powerful radio waves and magnets to create a detailed view of the body. This safe, painless test produces detailed3Dimages of the structural differences in the brain that may be contributing to the symptoms. You can also provide images of the cerebellum and determine if it extends into the spinal canal. AnMRIcan be repeated over time, and can be used to control the condition.
  • Computed tomography (CT scan).The health care provider may recommend other imaging tests such as aCTscan. ACTscan uses X-rays to obtain cross-sectional images of the body. This can help reveal brain tumors, damage to the brain, bones, and blood vessel problems, and other conditions.

Magnetic resonance imaging (MRI). An mri is often used to diagnose Chiari malformation. An mri uses powerful radio waves and magnets to create a detailed view of the body.

This safe, painless test produces detailed 3D images of the structural differences in the brain that may be contributing to the symptoms. You can also provide images of the cerebellum and determine if it extends into the spinal canal.

A magnetic resonance imaging can be repeated over time, and can be used to control the condition.

Computed tomography (CT scan). The health care provider may recommend other imaging tests such as ct scans.

A ct scan uses X-rays to obtain cross-sectional images of the body. This can help reveal brain tumors, damage to the brain, bones, and blood vessel problems, and other conditions.

Treatment

Treatment of Chiari malformation depends on your condition. If you have no symptoms, the doctor may recommend no treatment other than monitoring with regular exams and Mris .

When headaches, or other types of pain is the main symptom, your health care professional may recommend a medication for the pain.

The reduction of the pressure with the surgery

Chiari malformation that causes the symptoms are usually treated with surgery. The goal is to prevent further damage to the central nervous system. The surgery may also help lessen or stabilize symptoms.

The surgery may reduce the pressure on the cerebellum and the spinal cord and restore the usual flow of fluid from the spinal cord.

The most common surgery for a Chiari malformation is called decompression of the posterior fossa. The surgery involves removing a small section of bone in the posterior part of the skull. This relieves the pressure by giving more space for the brain..

During the surgery, the covering of the brain called the dura mater can be opened. Also, a review can be sewn in place to expand the coverage and provide more space for the brain. This patch may be an artificial material, or it could be fabric of the harvest from a different part of the body.

The surgeon may also remove a small portion of the spine to relieve pressure on the spinal cord and allow for more space.

The surgical technique may vary, depending on if you have a fluid-filled cavity called syrinx, or if you have fluid in the brain, known as hydrocephalus. If you have a syrinx, or hydrocephalus, you may need a tube called a shunt to drain the excess fluid.

The surgical risks and follow-up

The surgery involves risks, including the possibility of infection, fluid in the brain, cerebrospinal fluid leakage, or problems with the healing of the wound. Discuss the risks and benefits with your surgeon to decide if surgery is the most appropriate treatment for you.

The surgery reduces symptoms in most people. But if the nerve injury in the spinal canal has already occurred, this procedure does not reverse the damage.

After the surgery, you will need regular follow-up exams with your health care professional. This includes regular imaging tests to evaluate the outcome of the surgery and the flow of cerebrospinal fluid.

Preparing for your appointment

It is likely to start by seeing your health care professional. However, when you call to schedule an appointment, you may be referred to a doctor trained in brain and nervous system conditions, known as a neurologist.

Because appointments can be brief, and because there is often a lot to talk about, it is a good idea to be well-prepared for your appointment. Here's some information to help you prepare for your appointment and know what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do beforehand.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. For example, even though his main complaint that can be headaches, tell your health care professional about any changes in your vision, speech, or coordination.
  • Write down key personal information, including any major stresses and recent changes in life.
  • Make a list of your key medical information, including other conditions being treated, and the names of the medicines you are taking.
  • Have a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their health professional.

Prepare a list of questions so that you can make the most of your limited time during your appointment. A list of questions from most important to least important in case time runs out. For the Chiari malformation, some basic questions to ask include:

  • What is likely causing my symptoms or condition?
  • Other that the most likely cause, what are the possible causes of the symptoms or condition?
  • What kinds of tests do I need?
  • I need treatment?
  • If you do not think that needs to be treated now, how are you going to monitor me for the changes in my state?
  • If you recommend the surgery, what should I expect from my recovery?
  • What is the risk of complications of the surgery?
  • What is my long-term prognosis after the surgery?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • You should see a specialist? What will that cost, and will my insurance cover seeing a specialist?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

In addition to the questions you have prepared, do not hesitate to ask questions during your appointment if you do not understand something.

What to expect from your doctor

Your healthcare provider is likely to ask you some questions. Be ready to answer them may reserve time to go over any points you want to spend more time on. Your health care professional may ask:

  • When did you first begin experiencing symptoms?
  • The symptoms been continuous or occasional?
  • If you experience neck pain and headache, made worse by sneezing, coughing or straining?
  • How bad is your pain of the head and neck?
  • Have you noticed any change in the coordination, including problems with balance or coordination of the hand?
  • Make hands and feet, feeling of numbness or a tingling sensation?
  • Has developed any difficulty swallowing?
  • You are experiencing episodes of dizziness or fainting? Have you ever spent?
  • Has developed any kind of problems with his eyes and ears, such as blurred vision or a buzzing or humming in your ears?
  • Has had problems with bladder control?
  • Has anyone noticed that you stop breathing during sleep?
  • You have been taking pain relievers or the use of other methods to relieve your discomfort? Nothing seems to work?
  • Do you have any of these additional symptoms, such as hearing loss, fatigue, or changes in your bowel habits or appetite?
  • Have you been diagnosed with any other health conditions?
  • Has someone in your family has been diagnosed with a Chiari malformation?
Symptoms and treatment of Chiari malformation