Arnold Chiari Syndrome

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Arnold Chiari Syndrome- This is an abnormal development of the brain, in which the division of the skull containing the cerebellum is too small or deformed, as a result of which the brain is squeezed. The lower part of the cerebellum or tonsils are displaced to the upper part of the spinal canal. The pediatric form — Arnold Chiari Type III syndrome — is always associated with myelomeningocele (hernia of the spinal cord and meninges). The adult form - Chiari Type I syndrome - develops due to an insufficiently large posterior part of the skull.

Causes

When the cerebellum is pressed into the upper part of the spinal canal, it can interfere with the normal outflow of CSF, which protects the brain and spinal cord. Impaired circulation of cerebrospinal fluid can lead to blockade of signals transmitted from the brain to the underlying organs or to the accumulation of cerebrospinal fluid in the brain and spinal cord. The pressure of the cerebellum on the spinal cord or lower part of the brainstem can cause syringomyelia.

Diagnostics

The diagnosis is established by the results of MR imaging. If necessary, we perform computed tomography with a three-dimensional reconstruction of the occipital bone and cervical vertebrae.

Symptoms:

With the Arnold-Chiari anomaly, we usually observe two or three or more of the following symptoms:

  • Dizziness and / or unsteadiness (may increase with turning of the head);
  • Noise (ringing, hum, whistling, hissing, etc.) in one or both ears (may increase when turning the head);
  • Headache associated with an increase in intracranial pressure (stronger in the morning) or with an increase in the tone of the neck muscles (pain points under the back of the head);
  • Nystagmus (involuntary twitching of the eyeballs).

In more severe cases, the following are likely:

  • Transient blindness, double vision or other visual disturbances (may appear when the head is turned);
  • Tremor of the hands, feet, movement disorders;
  • Reducing the sensitivity of a part of the face, part of the trunk, one or more limbs;
  • The weakness of the muscles of the face, body, one or more limbs;
  • Involuntary or difficult urination;
  • Loss of consciousness (may be provoked by turning the head).

In severe cases, the development of conditions that threaten the infarction of the brain and spinal cord is likely.

Treatment

Treatment for the Arnold Chiari anomaly depends on the severity and condition of the patient. In the absence of symptoms, the doctor may prescribe only a supervised examination as a treatment for you.
If the primary symptoms are headache or other types of pain, the doctor may recommend pain relievers. For some patients, relief comes from taking anti-inflammatory foods. This may prevent or delay the operation.

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