Home DiseasesPediatric neurosurgery Chiari malformation and Syringomyelia

Chiari malformation and Syringomyelia

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Chiary malformation includes a group of diseases sharing an anatomical disorder at the position of the lower part of the brain and the cerebellum. Thus, part of the cerebellum may be outside the skull, migrating downwards to the craniocervical junction, thus compressing the spinal cord. There are 4 grades for the ectopic position of the anatomical elements. This disorder is usually accompanied by a disturbance of the circulation of the cerebrospinal fluid, both around and inside the spinal cord or the brain. MRI imaging can help us diagnose this disorder. Clinically, in Chiari malformation Type I, which is the most common, the symptoms may include severe headache, symptoms at the upper and lower extremities, disturbance of the sensation of hot and cold, gait instability, urination and bowel movement disorders, etc. Sometimes this syndrome is accompanied by other disorders, such as spine scoliosis.
Syringomyelia involves an excessive amount of cerebrospinal fluid inside the center of the spinal cord. The symptoms are similar to those seen in Chiari malformation, since these two conditions may coexist (cause-effect relationship). Syringomyelia may also develop following spinal cord injury (injuries, ischemia).
Chiari malformation is treated with surgery, with an incision in the back of the neck. An incision is made in the dura mater, to create an additional anatomical space for the circulation and drainage of the cerebrospinal fluid. Of course, the operation is performed under general anesthesia, it lasts about 2 hours and requires a hospital stay for 4-5 days. With the gradual balancing of the cerebrospinal fluid circulation, the symptoms gradually subside; syringomyelia may also subside. In the case of post-traumatic syringomyelia, unfortunately the course of the disease may not be as favourable, and it is more difficult to treat. In many cases, even the drainage of cerebrospinal fluid may not have the desired clinical results.