If you suspect Chiari malformation resulting due to the Arnold-Chiari syndrome, then a physical exam with the doctor has to be performed in order to diagnose the condition. The physician will also take up assessment of functions that are controlled by parts of the body, such as the cerebellum and the spinal cord.
The functions that may be affected are balance, reflexes, touch, sensation, and also motor skills. The doctor may recommend diagnostic tests like X-ray, CT scan and MRI. An MRI is a commonly used medical test for diagnosing Chiari malformations.
If Chiari malformations don't cause any symptoms, or if they do not interfere with your daily activities, then no treatment may be necessary. In other instances, medications can be employed for managing symptoms such as pain. Patients suffering from Chiari I malformations with minimal symptoms and without syringomyelia can be offered conservative treatments. Symptoms such as neck pain and headaches are usually treated with muscle relaxants, analgesics, and by using a soft collar. Surgery helps in significant reduction of the symptoms, which is invariably followed by an extended period of physical rest. Surgery is believed to eliminate 50 per cent of symptoms in paediatric cases and 45 per cent in other scenarios. For the remaining 5 per cent, the symptoms are stabilised.
Surgery is an important form of treatment that can rectify and address the functional defects, or halt the progression of damage towards the central nervous system. For type I and also type II Chiari malformations, the objective of a surgery is to relieve pressure on the organs such as the brain and the spinal cord, and also to restore normal fluid circulation in and around the area. For adults and children suffering from Chiari malformations, various surgeries can be opted for, such as:
This is a frequently performed surgery done for the removal of a comparatively small portion of the bottom of the skull and also a part of the spinal column, in order to correct the irregular bony structure. In this procedure, the patient is subjected to 'nothing by mouth (NPO)' and admitted during the morning. Anti-embolic stockings and few compression devices are usually applied. Antibiotic prophylaxis using cefazolin or vancomycin is administered within one hour of making the incision; dexamethasone and mannitol are also given. The surgeon will usually help with extending and widening the dura, which is the firm portion that encapsulates the brain and the spinal cord. The surgery creates additional space for the circulation of the cerebrospinal fluid. The surgery involves steps such as suboccipital craniectomy, duraplasty, cervical laminectomy, followed by arachnoid dissection.
This form of surgery involves removing a part of the bony and arched roof of the spinal canal, which helps in increasing the canal's size and also in reducing the pressure towards the spinal cord and the nerve roots.
This is a method that employs high-frequency electrical currents for shrinking the lower part of the cerebellum. There are some other additional surgical procedures, such as hydrocephalus, which can be performed for rectifying conditions related to Chiari malformations.
To cut it short, surgery is considered to be an effective cure by many people. Patients invariably opt for a surgery once the symptoms are properly assessed, as the medical procedure paves way for a longer and healthier life.