Surgery for Chiari Malformation
Chiari malformation is a condition in which the cerebellum (a structure in the back and bottom of the brain) protrudes into the spinal canal. Chiari type I malformation usually causes symptoms in young adults and is often associated with syringomyelia, in which a tubular fluid cavity develops within the spinal cord. Symptoms of Chiari type I malformation typically begin with headaches occuring when straining and may progress to numbness and weakness in the arms and legs, difficulty walking, and bowel and bladder problems. Surgical treatment of Chiari type I malformation is usually required to prevent progression of symptoms. Surgery typically consists of removal of bone at the base of the skull and the first cervical spine segment, followed by placement of a graft to expand the dura (the covering over the brain and spinal cord) to create more room for the descended cerebellum and take pressure off the spinal cord.
Chiari type II malformation is typically diagnosed shortly after birth. It is frequently associated with a myelomeningocele (a developmental defect of the spine) and hydrocephalus (abnormal accumulation of spinal fluid in the brain). Chiari type II malformation and its associated conditions are usually treated by pediatric neurosurgeons soon after birth.