Chiari Malformation

A Chiari malformation is when the lowest part of the brain extends into the spinal canal. “Sometimes it starts to push on the brain stem and the top of the spinal cord, which are not very forgiving, and also, again, block that flow of spinal fluid through there,” said Pediatric Neurosurgeon Dr. Theodore Spinks.
There are many different types of Chiari malformations. “The important thing to know is they're really not exactly the same problem, or they have different sources,” said Dr. Spinks.
Surgery is not always necessary. “Now that we get MRIs on everyone all the time, I see patients with Chiari malformations all the time. And what it really boils down to is even if they have a real Chiari and there's really a descent to that cerebellum, if there's no symptoms, usually you do nothing. Because there may never be symptoms, you may never need anything,” said Dr. Spinks.
For those dealing with classic symptoms like headaches, swallowing and sleeping problems, surgery can help. “The basic idea is you have a mechanical problem, right? You've got a hole with too much stuff in it. And it's being squished or it's blocking that flow of spinal fluid. So, the solution is to make more space. And the way to make more space is we could widen out that hole, so I take off a little bit of bone from the back of the skull to make that hole a little bit bigger. And then also the tissues around it I'll open up to provide more space and make sure we get good flow of spinal fluid through there,” said Dr. Spinks. You can learn more by searching for pediatric neurosurgery on leehealth.org.
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