Chiari I Malformation HF#5310

 

What is Chiari I Malformation?

 

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

 

4th Ventricle       Cerebellar Tonsils     Syrinx

 

Common symptoms of a Chiari I Malformation are:

• Headaches
• Neck, shoulder or arm pain
• Weakness or changes in the feeling in your hands, arms, or legs
• Symptoms that 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 the back 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, once pressure is relieved, the spinal cord cyst will go away in a few weeks or months.

 

Risks of this treatment include:

• CSF leak
• Infectin in the tissue that covers the brain
• Wound infection
   

Before Surgery

 

To prepare, you will have a work-up.  This includes a review of your health, an exam, and blood tests.  The night before and the morning of surgery, you will need to wash with an antibacterial soap, such as Dial.  Please do not use any lotions or powders after washing.

 

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). 

 

After Surgery

 

This operation may take about 3 to 5 hours.  You may spend the night of surgery 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:

 

• Severe headache
• Fever greater than 101.5 F
• Redness, swelling or drainage at the incision site
• Nausea or vomiting

 

Phone Numbers

 

If you have any questions, please call:

 

Catie, RN (608)262-2761

Lisa, RN   (608)890-6942

 

After hours, nights, and weekends, call the pager operator (608)262-0486.  Ask for the neurosurgeon on call.  Leave your name and phone number with the area code.  The doctor will call you back.

 

To schedule an appointment, call (608)262-0486.

 

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: 10/16/2012

Copyright © 08/27/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5310

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