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Introducing Chiari malformation -

A Chiari malformation is a (believed to be) rare chronic condition where the lower part of the brain pushes through the opening at the bottom of the skull.

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The four types -

There are four different types of Chiari malformation, but Chiari I is the most common. In people with Chiari I, the lowest part of the back of the brain extends into the spinal canal.

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Pressure on the brain -

This puts pressure on other parts of the brain and the spinal cord, and can cause mild to severe symptoms (although many people experience no symptoms at all).

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Causes -

We are not sure exactly what causes a Chiari malformation. What we do know is that usually the problem is congenital (i.e. it is present at birth).

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Diagnosis -

Often, however, the malformation is only discovered later in life when symptoms develop or when an MRI scan is done.

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Potential cause -

In many cases, it is believed that a Chiari malformation develops because there is a part of the skull that is not large enough for the brain.

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Causal developments -

Chiari I malformations are also known to develop in people with a tethered spinal cord, hydrocephalus (a buildup of cerebrospinal fluid), and some types of brain tumor.

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The role of genetics -

They can also run in families: it may be that some children inherit a faulty gene that causes problems during their skull development.

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Low risk -

It is important to remember, however, that the likelihood of passing on a Chiari malformation to your children is low. And even then, they may not experience symptoms.

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Symptoms -

So, what are the symptoms of a Chiari malformation? While it is possible to experience no symptoms at all, there are definitely symptoms that can develop.

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Headaches -

The main symptom reported by people with a Chiari malformation is headaches. These usually start at the back of the head and are made worse by coughing, sneezing, etc..

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Other symptoms -

Other symptoms include neck pain, dizziness and balance problems, muscle weakness, numbness or tingling in the legs, blurred or double vision, sensitivity to light, swallowing problems, hearing loss or tinnitus, nausea and vomiting, insomnia, and depression.

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Syringomyelia -

There is also the chance that someone with a Chiari malformation will develop syringomyelia (a fluid-filled cavity that develops in the spinal cord).

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Complications -

Syringomyelia comes with its own symptoms, and these include problems using your hands, difficulty walking, pain, and problems with bladder or bowel control.

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Seeking medical assistance -

People who experience these symptoms must seek medical attention, since syringomyelia can cause damage to the spinal cord if not properly treated.

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Treatment -

The treatment for a Chiari malformation depends on whether the patient experiences symptoms or not. If there are no symptoms, treatment is not always necessary.

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Pain management -

Furthermore, if the only symptoms experienced are moderate headaches and neck pain, doctors will usually prescribe painkillers to manage this.

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Surgery -

If, however, headaches are severe or there is some problem caused by pressure on the spinal cord (such as difficulty moving), surgery is sometimes required.

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Decompression surgery -

The most common surgery used to treat a Chiari malformation is called decompression surgery. During this procedure, a small piece of bone is removed from the bottom of the skull.

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How it works -

This reduces the pressure on the brain and allows fluid to flow normally around the brain and spinal cord.

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Results -

The main aim with decompression surgery is to stop the symptoms from getting worse, but some people even experience an improvement in their symptoms.

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Caveat -

Other people, however, notice a deterioration in their symptoms after surgery. There is also a small risk of serious complications, such as paralysis or stroke.

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Surgical alternatives -

In addition to decompression surgery, there are other procedures that are sometimes required to treat a Chiari malformation.

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Spinal fixation -

For example, some people with a Chiari I malformation will have a hypermobility syndrome, such as Ehlers-Danlos syndrome. These people may require a spinal fixation procedure to stabilize their spine.

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Other options -

Other procedures that are sometimes necessary include endoscopic third ventriculostomy (ETV), ventriculoperitoneal shunting, and spinal untethering.

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Conversation -

In cases where surgery is required to treat a Chiari malformation, the surgeon will talk to the patient about the different options and explain the benefits and risks of each.

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Raising awareness -

Chiari malformations are considered rare and awareness about them is low. Further research is definitely needed to better understand the condition.

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Spreading the word -

If you have been personally affected by Chiari malformation, you might find it helpful to share your experience with others. Together we can raise awareness for people struggling with this chronic illness.

Sources: (NHS) (Johns Hopkins Medicine)

See also: Helpful ways to deal with chronic pain

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