Chiari I Malformation

 

What is Chiari I Malformation?

 

In this condition, the back part of the brain extends into the spinal canal.  Each person has different symptoms based on how severe the problem is.  Many times people with this problem also have a spinal cord cyst (an abnormal collection of fluid).  This cyst could also be the cause of the symptoms.

 

 

Common symptoms of a Chiari I Malformation are headaches, pain in the neck, shoulders or arms, weakness or changes in the feeling in your hands, arms, or legs.  The symptoms come on slowly and become worse with straining or coughing.

 

Treatment of the Chiari I Malformation

 

Your doctor may suggest surgery to make room for the back part of the brain that extends into the spinal canal.  This often improves the symptoms or keeps them from getting worse.  Pressure on this part of the brain is relieved by taking off the bone lying over the area and opening up the tissue that covers the brain (dura).  When the pressure is relieved in this area, the normal flow of cerebral spinal fluid (CSF) is restored.  Often after this is done, the spinal cord cyst will go away over a few weeks or months.  Risks of this treatment include CSF leak, infection in the tissue that covers the brain, wound infection, and other neurologic problems.   

 

Before Surgery

 

To prepare, you will have a work-up.  This will include a review of your health, an exam, chest x-ray, electrocardiogram, and blood tests.  All of your questions will be discussed, and you will be asked to give your consent for this treatment.

 

During Surgery

 

A small amount of hair on the back of your head is shaved.  An up and down incision is made from the middle of the neck to the back of your head.  After more room is made for the back of the brain, the tissue cover of the brain (dura) is stitched together.  A dural patch graft is used which may come from your own tissue or from a man-made patch (Gore-Tex).  Ask your doctor what kind of graft he uses.

 

After Surgery

 

This operation may take about 3 to 5 hours, and you may spend one night in the intensive care unit.  When you are stable, you will be moved to a general care floor for a total stay of about 3 to 5 days.

 

It is best to avoid coughing, lifting, and straining for the next 3 months.  If you should become sick with a severe cough during this time, a doctor may prescribe a cough medicine.  You and your doctor will decide when you should return to work.

 

When to Call the Doctor

 

Call if you have any of the following symptoms.

 

• severe headache
• fever of 100.4° F or greater
• watch for signs of infection around the incision

redness

swelling

drainage

• nausea or vomiting

 

Phone Number

 

Department of Neurosurgery at (608) 263-9651

 

After hours, nights, and weekend, this number will be answered by the message center.  Ask for the neurosurgery resident on call.  Leave your name and phone number with the area code.  The doctor will call you back.

 

If you live out of the area, call 1-800-323-8942.

 

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 11/11/2009

Copyright © 11/11/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #5310

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