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What Causes Chiari Malformation?
Question: My PCP has referred me to a Neurosurgeon at UTSW here in XXXXXXX based on the Chiari 1 visible in my MRI and my recent balance, speech, and fatigue issues. This surgeon and his group do a lot of complex skull base surgery to treat brain tumors, but he is not a Chiari expert.
My question is: Shouldn't I first see a neurologist expert in evaluating Chiari and related symptoms? Are there not tests that could be used to establish that my symptoms are indeed related to the Chiari since I have had the chiari all my life probably but only have had sever symptom for a few months? And having established that, determine what level of intervention is needed? (PF decommpression, laminectomy, dural opening, tonsil removal)
I have been asking around for several weeks now and I have concluded that there is no stand out Chiari expert in XXXXXXX
Thank you for your response,
XXXX
My question is: Shouldn't I first see a neurologist expert in evaluating Chiari and related symptoms? Are there not tests that could be used to establish that my symptoms are indeed related to the Chiari since I have had the chiari all my life probably but only have had sever symptom for a few months? And having established that, determine what level of intervention is needed? (PF decommpression, laminectomy, dural opening, tonsil removal)
I have been asking around for several weeks now and I have concluded that there is no stand out Chiari expert in XXXXXXX
Thank you for your response,
XXXX
Brief Answer:
I think you should go for decompression.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
I agree with your Doctor's opinion, consulting a Neurologist is not necessary in your case.
Chiari malformation is a developmental malformation and in some people may never result in symptoms, in others can cause problems in a certain time of their lives from childhood to adulthood.
All Neurosurgeons are trained to evaluate properly indications for surgery and to treat Chiari malformation surgically, so, I think you should consult with your Neurosurgeon first.
Most cases of Chiari I malformation are treated surgically by posterior fossa decompression, opening of the dura ( with or without dural graft ) and C1 posterior laminectomy, but the surgical approach should be decided considering your clinical status and imaging studies results.
Since you refer recent severe symptoms, you should go for decompression.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.
I think you should go for decompression.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
I agree with your Doctor's opinion, consulting a Neurologist is not necessary in your case.
Chiari malformation is a developmental malformation and in some people may never result in symptoms, in others can cause problems in a certain time of their lives from childhood to adulthood.
All Neurosurgeons are trained to evaluate properly indications for surgery and to treat Chiari malformation surgically, so, I think you should consult with your Neurosurgeon first.
Most cases of Chiari I malformation are treated surgically by posterior fossa decompression, opening of the dura ( with or without dural graft ) and C1 posterior laminectomy, but the surgical approach should be decided considering your clinical status and imaging studies results.
Since you refer recent severe symptoms, you should go for decompression.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.
Above answer was peer-reviewed by :
Dr. Prasad
I know so NS prefer to reduce the tonsils and not do the laminectomy. While I am initially reluctant to have any of my brain removed, I also am reluctant to have the bony support oh my skull reduced. I dont want to end up with a painful cracked c1 in a few years.
How does a NS determine if the tonsils should be reduced?
Thanks for your response. Your previous response went to junk so I just now read it. I will check junk in the future.
XXXXXXX
How does a NS determine if the tonsils should be reduced?
Thanks for your response. Your previous response went to junk so I just now read it. I will check junk in the future.
XXXXXXX
Brief Answer:
Decompression is the most used procedure.
Detailed Answer:
Welcome back.
The most widely accepted treatment of CIM ( Chiari I malformation) is a posterior fossa decompression with removal of the posterior arch of C1 and dural augmentation graft. The goal of surgery
is to enlarge the posterior fossa and permit normal flow of CSF ( cerebrospinal fluid ) from the posterior fossa to the cervical subarachnoid space.
Tonsils are removed only in rare cases where no sufficient decompression is achieved by above mentioned procedure.
Removal of C1 posterior arch doesn't cause any problems in the majority of cases.
Hope I helped you.
Best regards.
Decompression is the most used procedure.
Detailed Answer:
Welcome back.
The most widely accepted treatment of CIM ( Chiari I malformation) is a posterior fossa decompression with removal of the posterior arch of C1 and dural augmentation graft. The goal of surgery
is to enlarge the posterior fossa and permit normal flow of CSF ( cerebrospinal fluid ) from the posterior fossa to the cervical subarachnoid space.
Tonsils are removed only in rare cases where no sufficient decompression is achieved by above mentioned procedure.
Removal of C1 posterior arch doesn't cause any problems in the majority of cases.
Hope I helped you.
Best regards.
Above answer was peer-reviewed by :
Dr. Sonia Raina
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