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Chiari Malformation Advice

By AGE2B team
January 31, 2022

Chiari malformation is a neurological disorder where part of the brain tissue, either part of the cerebellum, or part of the brainstem descends into the foramen magnum(an opening at the base of the skull) and into the spinal area. It occurs when part of the skull is abnormally small or misshapen, thereby adding pressure to the brain and pushes it downward.

Some Chiari malformations do not show symptoms and do not interfere with a person’s activities of daily living. A headache is the hallmark sign of a Chiari malformation, especially after sudden coughing, sneezing, or straining. Other symptoms may vary among individuals and may include the following:
  • Neck pain worsened by valsalva,
  • Dizziness,
  • Vomiting,
  • Muscle weakness or numbness,
  • Difficulty swallowing or speaking,
  • Tinnitus (ringing in the ears) and hearing loss,
  • Scoliosis,
  • Insomnia,
  • Depression,
  • Problems with hand coordination and fine motor skills.
Treatment of Chiari malformation depends on the form, severity, and symptoms. Regular monitoring, medications, and surgery are the treatment options. But what happens if Chiari malformation goes untreated?

What happens if Chiari malformation goes untreated?

Chiari malformation can become a progressive disorder and may lead to serious complications. Some complications associated with untreated and progressive Chiari malformation are:
  1. Hydrocephalus. This is an accumulation of cerebrospinal fluid in the brain and causes increased pressure inside the skull. Patients with hydrocephalus may experience headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In younger children, there may be a remarkable increase in the head size. Other symptoms may include vomiting, seizures, sleepiness, and downward pointing of the eyes. This condition may require shunt placement to divert and drain the cerebrospinal fluid.
  2. Spina bifida. It is characterized by incomplete development of the brain, spinal cord, or its covering. Part of the spinal cord is exposed, which can cause paralysis.
  3. Syringomyelia. It is a condition in which a fluid-filled cavity or cyst forms within the spinal cord, which can damage the spinal cord if not treated promptly. The symptoms of syringomyelia may include numbness, weakness, pain, stiffness, problems with bladder and bowel function and paralysis.
  4. Tethered cord syndrome. In this condition, the spinal cord attaches to the spine and causes the spinal cord to stretch. This can cause serious nerve and muscle damage in the lower half of the body.
  5. Curvature of the spine. The spine might curve abnormally to the left or right (scoliosis), or abnormally outwards (kyphosis).

When to see a doctor?

Treatment of Chiari malformation depends on the symptoms and its severity. Asymptomatic patients may not need any treatment at all. Painkillers can help relieve mild headaches and neck pain. But if you are experiencing any of the signs and symptoms that may be associated with Chiari malformation that is severe enough to interfere with your daily activities, make sure to visit your doctor for an evaluation. Because many symptoms of Chiari malformation can be associated with other disorders, a thorough evaluation is important.
Most doctors will use a combination of reported symptoms, a neurologic MRI, and their experience and judgment. The type of surgery will differ from person to person and some may need more than one operation as part of their treatment. The neurosurgeon will discuss these options upon diagnosis.

Here are some tips you can follow to manage Chiari Malformation:

1. To help avoid headaches with Chiari malformation, wear shoes that provide cushioning and support.

2.  People with Chiari malformation should avoid activities that cause stress on their neck. This includes things like football, roller coasters, and heavy lifting. You should also avoid things like falling asleep in a chair.

3.  Sleep is especially important for people with Chiari malformation. Try to get 8 hours of sleep every night. Headaches might be prevented by elevating the head of your bed with blocks placed under the front of the bed frame.

4.  If you have ringing in your ears, you should avoid aspirin, alcohol, and caffeine, and limit the amount of salt in your diet.

5.  Keep your body in excellent physical condition by walking or bicycling to prevent symptoms of Chiari malformation.

6.  When reclining, make sure your chair has a high back to support your neck.

7.  Everyone, not just people with Chiari malformation, should read looking straight ahead. When you’re working on the computer, the monitor should be at eye-level. Support books or magazines on book holders.

8.  When driving, use wide-view mirrors.

9.   Avoid excessive noise and stress. Relax and keep your neck tension-free.

10.  When you feel a Chiari malformation headache start, lie down and apply cold compresses to the back of your neck for an hour or so.

11.  Straining to have a bowel movement can bring on a headache, so people with Chiari malformation need to avoid constipation. Include fiber in your diet and drink plenty of water.

12.  Avoid wearing heavy necklaces, scarves, and tight collars around your neck.

13.  Dizziness is a problem for some people with Chiari malformation. Avoid prolonged standing. If you have to wait in line, try focusing your eyes on one object in front of you, or try closing one eye.

14.  Everyone, not just those with Chiari malformation, can help their short-term memory by playing cards or doing crossword puzzles.

15.  Taking a calcium supplement may be right for you if you have Chiari malformation, but check with your doctor first.

16.  Some patients with headaches related to Chiari malformation find TENS treatments helpful but check with your doctor before using TENS.

17.  Cervical traction should be avoided in people with Chiari malformation.

18.  If your medical provider suggests an epidural injection or lumbar puncture, ask for a second opinion. These procedures can be dangerous for people with Chiari malformation.

19.  Tell your beautician you have Chiari malformation. Most beauty shops have a special way to shampoo your hair so you can avoid leaning back on the rim of the shampoo bowl.

20.  People with Chiari malformation should not have chiropractic adjustments because chiropractors are not experienced in this condition.

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