If your physician has recently called you to tell you that you have a Chiari 1 malformation after getting an MRI of your head and neck, you probably have a lot of questions on your mind as you wait for your first appointment with a neurosurgeon. Here is a basic rundown of what Chiari 1 malformation is and how it can be treated.
What Is Chiari 1 Malformation?
A Chiari 1 malformation is when the cerebellum, which is at the base of the brain, descends through the foramen magnum, which is the opening for the spinal cord. Essentially, the bottom of your brain doesn't have enough room, so it goes downward into the spinal cord. This protrusion into the spinal cord is called a herniation. It is important to understand that this is a progression condition, and the herniation into the spinal cord can block the flow of the cerebral spinal fluid, which normally flows from the brain to the spinal cord.
Of course, any blockage in the flow, whether fully or partially, can cause a wide range of things to happen, including hydrocephalus and paralysis. This depends on the blockage of the fluid and whether or not the brain stem, spinal cord, and/or nerves are damaged due to compression from the herniation. The most common complaint of Chiari 1 malformation is a pressure headache in the back of the head. Other common symptoms of this condition includes numbness and tingling throughout the body, particularly in the extremities.
Chiari Is Treated by Neurosurgery
Since the flow of the cerebral spinal fluid is crucial, your neurosurgeon may send you for a cine MRI, which will give him or her a movie-like image to base their recommendations for treatment on. Obviously, if there is a blockage of the flow, then surgery will probably be recommended.
However, it is extremely important to try lifestyle changes first and only consider neurosurgery when the symptoms are life-threatening or drastically affect your normal daily activities, such as difficulty walking due to numbness or difficulty swallowing due to the herniation compressing on the medulla oblongata of the brain stem. An example of a lifestyle change would be to avoid bending over from the waist if doing so causes a Chiari headache.
The reason for this is because a Chiari decompression surgery is quite serious, as it involves removing a portion of the skull and sometimes involves cutting the dura, which is the lining in between the brain and the skull, depending on the size of the herniation and/or a blockage of the cerebral spinal fluid.
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