Chiari malformations, Down Head Pain
Chiari malformations are structural defects in the cerebellum. This part of the brain that controls balance.
Some people with Chiari malformation may have no symptoms, while others may have symptoms such as:
dizziness, muscle weakness, numbness, vision problems, headaches, problems with balance and coordination. Chiari malformation affects women more often than men.
Scientists once believed that Chiari malformation occurs only 1 out of every 1,000 births. But Increased use of diagnostic imaging techniques such as CT scans and MRI shows that these conditions are found.
Once an accurate examination is often difficult to do, it is because some children are born with good condition never experience symptoms until they reach adolescence or adulthood.
The cause of Chiari Malformation
Chiari malformation is usually caused by structural defects in the brain and spinal cord. These defects develop during fetal development.
Due to genetic mutation or the mother's diet deficient in certain nutrients, space at the base of the skull bone protrudes abnormally small. As a result, the cerebellum under pressure. It inhibits the flow of cerebrospinal fluid. This fluid that protects the brain and spinal cord.
Most Chiari malformation occurs during fetal development. Rarely, Chiari malformation may develop after that. This can occur when excessive amount of cerebrospinal fluid drained due to injury, infection or exposure to toxic substances
Chiari Malformation Type
There are four types of Chiari malformations:
This is the type most commonly observed in children. In this type, the bottom of the cerebellum - but not including the brain stem - extends to the opening at the base of the skull. opening called the foramen magnum. Typically, only the spinal cord pass through this opening.
This is usually only seen in children born with spina bifida. Spina bifida is the incomplete development of the spinal cord and / or its protector.
Type II is also known as the "classic" Chiari malformation or Arnold-Chiari malformation. In Chiari malformation type II, both the cerebellum and brain stem extends into the foramen magnum.
This is the most serious form, involving protrusion or herniation of the cerebellum and brain stem through the foramen magnum and into the spinal cord. This usually leads to severe neurological disability. Type III is a rare type.
It involves the brain incomplete or undeveloped. Sometimes associated with the open part of the skull and spine. Type IV is a rare breed.
In addition to spina bifida, another condition sometimes associated with Chiari malformation include:
Hydrocephalus. An excessive buildup of cerebrospinal fluid in the brain.
Syringomyelia. A disorder in which cysts develop in the central canal of the spinal cord's.
Syndrome nerve terminations. A progressive disorder in which the spinal cord attaches to the spine.
The curvature of the spine. This includes conditions such as:
scoliosis (spine bending to the left or right)
kyphosis (forward bending of the spine)
Pain from the head to the neck,
Dizziness and problems with balance,
Respiratory disorders during sleep,
Headache (especially the bottom) will be felt during
cough or sneeze
strenuous physical activity
trying to defecate
Treatment of Chiari Malformation
If the Chiari malformation is suspected, the doctor will perform a physical examination. The doctor will also check functions are controlled by the cerebellum and spinal cord. These functions include the balance, touch, reflexes, sensation, motor skills
The physician may order diagnostic tests, such as:
MRI is a test that is most often used to diagnose Chiari malformation.
If Chiari malformation causes no symptoms and do not interfere with daily activities, no treatment is necessary. In other cases, the drug can be used to manage symptoms such as pain.
Surgery is the only treatment that can improve functional disability or stop the progression of damage to the central nervous system.
In both type I and type II Chiari malformation, the goal of surgery is to:
Reduce the pressure on the brain and spinal cord
To form normal fluid circulation around the region
In adults and children with Chiari malformation, some types of surgery can be performed. These include:
Posterior fossa decompression surgery. It involves the removal of a small portion of the bottom of the skull and sometimes part of the spine to correct irregular bone structure. The surgeon is also able to open and widen the dura. The section covers the brain and spinal cord tissue. This creates additional space for cerebrospinal fluid circulation.
Electrocautery. It uses a high-frequency electric current to turn the lower part of the cerebellum.
Spinal laminectomy. It is the removal of the curved roof of the spinal canal bone. This increases the size of the canal and reduce pressure on the spinal cord and nerve roots.
Additional surgical procedures may be necessary to improve conditions associated with Chiari malformations such as hydrocephalus.
Surgery usually results in a significant reduction of symptoms and prolonged.