Chiari malformation is a structural abnormality in the brain where the cerebellum is located in a lower position than is normal. In these cases, the cerebellum is situated below the opening to the spinal cord. When the cerebellum occupies this lower position, more pressure is exerted on the cerebellum and the brain stem. This affects the functions they control, which include balance and motor control.
While medications can be used to manage some symptoms of Chiari malformation, surgery is the only treatment that can correct functional defects or stop the progression of damage to the central nervous system. The team at Texas Neurosurgery has extensive experience with this complicated surgery.
What causes Chiari malformation?
Most Chairi malformations occur during fetal development. They occur more frequently in females. It was assumed before imaging techniques such as CT scans and MRIs that Chiari malformations were about 1 in every 1,000 births, but these new scans point toward higher numbers. Plus, some children born with the condition never show symptoms or don’t develop symptoms until adolescence or adulthood.
Chiari malformations are caused by either genetic mutations or a maternal diet lacking in certain critical nutrients causing the indented bony space at the base of the skull to be abnormally small. This places pressure on the cerebellum and blocks the flow of cerebrospinal fluid (the fluid that surrounds and protects the brain and spinal cord). There are various types of Chiari malformation.
Symptoms of Chiari malformation
Symptoms vary by the type of malformation, but the most common symptoms are linked to problems with the function of the nerves in the brain stem. These include:
- Swallowing difficulties
- Breathing irregularities
- Weakness in the vocal cords
- Problems with the nerves in the throat and tongue
- Numbness in the arms or legs
Surgical options for treating Chiari malformation
The goal of surgery is to make more room for the cerebellum and to relieve pressure on the spinal cord. This can be accomplished with a suboccipital craniectomy. This procedure is performed with the patient under general anesthesia. We make an incision in the scalp at the back of the head. A specialized drill is used to create a hole in the skull bone, and a portion of bone is removed. In some cases, this alone may provide enough room to relieve symptoms. But in other cases, the dura (the covering of the brain and spinal cord) will be opened and enlarged using a graft.
If you or your child is suffering from any of the symptoms listed above, please make an appointment with the team at Texas Neurosurgery and let’s check for Chiari malformation or other possible causes. Call us at 214-823-2052.
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