Arnold Chiari syndrome is one of the neurological abnormalities seen in children that may be associated with a wide range of symptoms. This abnormality can be diagnosed and treated by the most skilled doctors in Turkey.
What is Arnold Chiari Malformation?
Arnold Chiari Syndrome Patterns
The size of the skull is small, which causes high pressure during the development of the skull during the growth period of the child. This pattern is seen in the late childhood stages (adolescence), where the pressure increases and the cerebellum descends down through the large foramen towards the vertebral canal. This pattern can occur due to acquired causes that raise pressure (such as infections and drugs This is the lightest form and the best warning.
In this pattern, a greater amount of cerebral tissue descends through the foramen magnum towards the vertebral canal. We see a drop in the cerebellum and part of the brain stem in younger children. This pattern is associated with another neurological malformation affecting the spine that has the name of myelomeningocele, which is A type of spina bifida malformation.
It is the most serious type where the cerebellum and brainstem descend through the large fossa into the vertebral column. This type is rare and with poor prognosis. This type is diagnosed in newborns or during pregnancy by ultrasound.
This type includes an underdeveloped cerebellum or an underdeveloped cerebellum. In this type, the cerebellum is in its normal position, but parts of the cerebellum are underdeveloped. This type is very rare, as it is the rarest of all the types.
Symptoms of Arnold Chiari Syndrome
The malformation can be asymptomatic, detected by chance and does not require treatment, often in the first type of Chiari anomaly, or it may be associated with many symptoms, especially those related to cerebellar functions. We mention some of the symptoms:
- Headache and pain in the neck and base of the head, especially when coughing
- There are defects in the central equilibrium
- Numbness and tingling
- Poor muscle coordination
- Loss of feeling in the hands or feet
- Some have visual problems
- Weak vocal cords (speech difficulties)
- Dysphagia and problems swallowing
- Sudden death can happen
Arnold Chiari defect diagnosis
Head MRI comes to the fore and is the best in diagnosis.
3D CT can also be used when diagnosing the patient, so that the need for intervention and prognosis can be determined.
Arnold Chiari syndrome treatment
Treatment is primarily aimed at relieving symptoms and improving quality of life.
In fact, the treatment of Chiari malformation depends on the severity of the condition and the symptoms. In the absence of symptoms, there is no need for treatment, but in the event of severe symptoms, the intervention must be carried out as soon as possible.
In mild cases, some symptoms such as headaches can be treated with analgesics as an occasional treatment only used in mild cases.
The cornerstone is the surgical procedure that is carried out in advanced centers and with a selection of qualified doctors andTurkey One of the best examples of this.
In fact, the main objective of the surgical procedure is to relieve pressure and drain the cerebrospinal fluid, and to do this we resort to the following well-known technique:
It is the surgical procedure used, which depends on removing a small part of the base of the skull, and we can suffice with this amount to relieve pressure.
In some cases, the surgeon resorts to opening the dura and exposing the cerebellar tonsils.
The surgeon reduces the size of the cerebellar tonsils by electrocautery, which leads to decompression and drainage of cerebrospinal fluid.
The decompression process takes decompression surgery The traditional procedure that involves opening the epidural takes about 3 to 4 hours, while the procedure without opening the epidural takes about two hours.
Surgical techniques for draining the fluid
Laparoscopic third ventriculostomy
One of the advanced and precise surgical techniques, where the surgeon inserts a small camera into the brain through a small hole in the skull and makes a small hole in one of the ventricles, which leads to pressure relief, a video of the operation from Here.
Some patients complain of headache and nausea for several days after the procedure.
A good technique is in the case of hydrocephalus because of the excessive accumulation of fluid, where we place a shunt that draws fluid from the brain and places the other end of the catheter in the peritoneal cavity.
The shunt may be associated with complications such as the transmission of infection to the brain or mechanical problems such as blockage of the shunt or displacement of the shunt from its place.
Risks of decompression surgery
- Heavy bleeding as a result of an artery injury and hematoma formation
- Cerebrospinal fluid leak
- Infection or stroke
- Anesthesia related disorders
- A complication that can also occur is a cranial nerve injury
- In some cases, symptoms do not improve after surgery
Preparation before surgery
Recovery after decompression surgery
Avoid constipation by drinking plenty of water, eating fiber, avoiding prolonged coughing, and preventing the patient from any strenuous activity such as housework.
You should not take NSAIDs or thinners without consulting your doctor.
The patient must commit to rest for a period of four weeks at least.
Surgical success rate (decompression surgery)
In fact, the success rate of decompression surgery according to Studies It reaches 85%, which means that the surgery is fairly safe.
85% of 95% patients had symptoms after decompression surgery.
The success of the surgical procedure depends on the health status of the patient, and if the surgeon opens the dura, or does he only remove part of the base of the skull.
The incidence is estimated at 1 in every 1,000 births and is often asymptomatic and often detected by chance when imaging is performed for other reasons.
Arnold-Chiari syndrome type II is almost always associated with myelomeningocele, a type of spina bifida.
Here, spina bifida is a serious congenital anomaly that requires urgent intervention after birth.
The most important frequently asked questions about Arnold Chiari and her treatment in Turkey
Is Chiari malformation a serious condition?
Is Chiari malformation a type of genetic disease that runs in families?
How is Arnold Chiari malformation treated?
In fact, there is no cure for Arnold Chiari malformation, but surgery can be performed to relieve symptoms in severe cases.
What should a patient with Arnold Chiari syndrome avoid?
Arnold-Chiari syndrome patients should avoid activities that raise pressure in the lower head, such as weightlifting, scuba diving, or sports that involve intense physical contact, such as boxing.
Does Chiari's deformity get worse with age?
Chiari malformation may worsen with age due to increased pressure during the child's development, leading to a more severe descent of the lower part of the brain into the vertebral canal.