Chiari Malformation

Chiari malformation is a structural defect where brain tissue extends into the spinal canal. It occurs when part of the skull is abnormally small or misshaped, pushing the lower part of the brain (cerebellum) down through the foramen magnum, a natural opening at the skull base. This compression can disrupt the flow of cerebrospinal fluid and affect brain function. Chiari malformations are classified into types, with Type I being the most common and typically diagnosed in adulthood, while more severe forms (Type II, III, and IV) are often detected at birth.

Causes

Chiari malformations are usually congenital, meaning they are present at birth, caused by structural defects during fetal development. In some cases, Chiari malformation can be acquired later in life due to injury, infection, or excessive drainage of cerebrospinal fluid from the spine. While the exact cause is not always clear, genetic factors may play a role in predisposing individuals to the condition.

Symptoms

Symptoms of Chiari malformation can vary depending on the severity of the condition. Common symptoms include headaches, particularly after coughing, sneezing, or straining, as well as neck pain, dizziness, balance issues, and difficulty swallowing. Other symptoms may include numbness or tingling in the hands and feet, muscle weakness, and coordination problems. In severe cases, it may lead to issues with breathing or the development of hydrocephalus.

Treatment

Treatment for Chiari malformation depends on the severity of symptoms. Mild cases without significant symptoms may only require regular monitoring. For patients with more severe symptoms, surgery is the most common treatment option. The primary surgical procedure, called decompression surgery, aims to create more space for the brain by removing part of the bone at the back of the skull, thereby relieving pressure and restoring normal fluid flow. Physical therapy may also be recommended to help with mobility and coordination issues.