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Chiari Malformation

Chiari malformations in adults occur when there is a lack of space for the cerebellum, which is the part of the brain that controls balance and coordination.  When the space at the bottom back of the skull is smaller than it should be, the cerebellum and the brainstem may be pushed downward. The pressure on the cerebellum can block the flow of cerebrospinal fluid and cause an array of symptoms.

To help diagnose Chiari malformation, our experts will ask about your symptoms and conduct a thorough physical
exam, as well as order MRI imaging. The treatment for Chiari malformation depends on the severity of your condition. For people who show symptoms, decompression surgery is often the best option.

The goals of Chiari malformation treatment include:

  • Reducing pressure on the nerve tissue
  • Creating normal flow of cerebrospinal fluid around and behind the cerebellum
  • Malformations that cause no symptoms should be left alone and do not require surgery. Although medications may ease the pain associated with a Chiari malformation, surgery is the only treatment that will correct functional disturbances or stop the progression of damage.

Surgery to Reduce Pressure

The most common operation for Chiari malformation in adults — called posterior fossa decompression —
involves removing a small section of bone in the back of the skull.

  • Neurosurgeons open the covering of the brain (the dura) and sew a patch in place to enlarge the covering.
    This provides more room for the brain and relieves the pressure.
  • Surgeons treat pediatric Chiari malformation similarly, although the decompression is usually followed at lower
    levels to decompress the spinal canal.

Other treatment options may include:

Shunting — Rarely, we may need to use a shunt to drain the cerebrospinal fluid from the brain to the
abdomen to control the problem in adults.