Pictured: Seymour Diamond, MD (photo by Linda Schwartz Photography)
SYMPTOMS IN ADVANCED CASES OF CHIARI MALFORMATION
When the Chiari malformation progresses, it can lead to serious complications including: 1. Hydrocephalus: Hydrocephalus is a build-up of fluid inside the skull. The word, hydrocephalus, means “water on the brain.” When present, patients have severe headaches and episodes of blurry vision. 2. Paralysis: This can be caused by increased pressure and crowding of the upper spinal cord structures. 3. Syringomyelia: In some people, a cyst (called syrinx) may form within the spinal cord.
of the descent of the cerebellar tonsils below the foramen magnum. Downward extension of the cerebellar tonsils up to 3mm is considered normal. When the cerebellar tonsils lie 3 to 5 mm below the foramen magnum, it is considered borderline. Extension of the cerebellar tonsils below the foramen magnum (more than 5mm) is considered abnormal.
TREATMENT
Chiari malformation type I is often an incidental finding and does not require treatment when patients do not have symptoms or if the symptoms are mild. If the malformation is considered abnormal, then more aggressive treatment may be required. Surgical treatment may be considered. The surgical intervention of choice is decompression of the posterior fossa. The posterior cranial fossa contains the brainstem and cerebellum. In symptomatic patien G2?7W&v?6?FV6??&W76????2&V6???V?FVB??F?R&W6V?6R?b7?&????WfV??bF?RF?V?BF?W2??B?fR7??F??2'WBF?W2?fR?76?6?FVB7?&????7W&v?6?FV6??&W76?????&R?VVFVB??b??G&?6W??W2?2&W6V?B?6?V?B7?7FV???&R?6VBF?G&??F?RW?6W7254b???&FW"F?&V?WfRF?R&W77W&R?p??D?t??4?0?gFW"?'F????rF??&?Vv???7F?'?g&??F?RF?V?B?F?R??6?6??W&f?&?2FWF??VB?WW&???v?2W???F????F?RF?v??6?2?b6??&???f?&?F???G?R??26?'&?&?&FVBv?F?'&????v??r&VfW&&?v?F??v?WF?2&W6???6R??v??r??$????$??bF?R'&??&?f?FW2FWF??VB?F?&VR?F??V?6?????7GW&R?bF?R'&???6??R??6R6??G&7B?$?6??V?FWFW&??RF?Rf??rG???72?b54b?6??WFVBF???w&???5B??bF?R?VB6??V??FV?F?g???&???&??&??F?W2?"F?R&W6V?6R?b??G&?6W??W2?5B?2W7V??F??Rv?V???$??26??G&??F?6FVB?F?R6WfW&?G??b6??&???f?&?F???FWV?G2??F?R&W6V?FF????b7??F??2?BF?RW?FV?@??wwr??VF6?W2??&p??????F?????VF6?Rf?V?FF??????