Chiari Malformation

Overview

Chiari malformation, also known as kee-AH-ree mal-for-MAY-shun, is a structural abnormality where brain tissue extends into the spinal canal. This occurs due to misshapen or smaller-than-typical skull anatomy, leading to pressure on the brain and downward displacement. Although not common, increased use of imaging tests has led to more diagnoses. Health care professionals classify Chiari malformation into three types based on brain tissue anatomy and developmental changes in the brain or spine:

1. Type 1: Develops during skull and brain growth, with symptoms often appearing in late childhood or adulthood. Classic symptoms include severe headaches triggered by coughing, sneezing, or straining. Other symptoms may include neck pain, balance issues, poor hand coordination, numbness, tingling, dizziness, and trouble swallowing.
2. Type 2: Involves a greater amount of tissue extending into the spinal canal compared to Type 1. It is often associated with a form of spina bifida called myelomeningocele, where the backbone and spinal canal don’t close properly before birth. Symptoms include changes in breathing pattern, swallowing difficulties, and quick downward eye movements.

Types of Chiari Malformation

1. Chiari 1 Malformation: The most common type, it typically presents during late childhood or adulthood. Symptoms include headaches, neck pain, balance problems, and numbness. Less common symptoms involve ringing in the ears, weakness, slow heart rhythm, and curvature of the spine.
2. Chiari 2 Malformation: Associated with myelomeningocele, a congenital condition where the spinal canal doesn’t close properly before birth. Symptoms include breathing changes, swallowing difficulties, and rapid downward eye movements.

Causes of Chiari Malformation

Several factors contribute to Chiari malformation:

• Structural Defects: Abnormalities during fetal brain and spinal cord development.
• Genetic Mutations: Some cases may have a hereditary component.
• Maternal Diet: Imbalanced maternal diet during pregnancy.
• Trauma or Injury: Brain trauma or injury.
• Brain Tumor: Presence of brain tumors.
• Infection: Infections affecting the brain.

Risk Factors of Chiari Malformation

Family History: Evidence suggests a genetic predisposition.

Symptoms of Chiari Malformation

Preventions of Chiari Malformation

1. Regular Check-ups: Attend routine medical check-ups to monitor your health and detect any abnormalities early.
2. Avoid Trauma: Take precautions to prevent head or spinal injuries, as trauma can exacerbate Chiari malformation.
3. Healthy Lifestyle: Maintain a balanced diet, exercise regularly, and manage stress to support overall well-being.
4. Genetic Counseling: If you have a family history of Chiari malformation, consider genetic counseling before planning a pregnancy.

Diagnosis of Chiari Malformation

Imaging Tests: Magnetic resonance imaging (MRI) and computed tomography (CT) scans provide detailed images of the brain and spinal column.

Treatment for Chiari Malformation

Treatment Options:

• • Medication: Ibuprofen for pain relief.
  • Surgical Procedures:
    • Posterior Fossa Decompression: Removing a small part of the skull.
    • Craniotomy: Opening the brain covering and using tissue patches.
    • Laminectomy: Removing a portion of the spinal column.
    • Ventriculoperitoneal Shunting: Draining excess fluid from the brain.
  • Self-Care: Ice packs, adequate sleep, maintaining a healthy weight, and a nutritious diet.

When to seek medical attention ?

If you experience severe headaches, neck pain, balance issues, or other symptoms associated with Chiari malformation, seek medical attention promptly.