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Chiari malformation and syringomyelia

Malformatio Chiari et syringomyelia · Chiariho malformace a syringomyelie

What it is

In Chiari I malformation the lowest part of the cerebellum sags through the skull's opening and blocks spinal fluid; a fluid-filled cavity (syrinx) may form in the cord. Often found by chance on MRI and then needs no treatment.

Symptoms & signs

  • Headache at the back of the head on coughing or straining
  • neck pain
  • dizziness, trouble swallowing
  • cape-like loss of pain and temperature feeling (syrinx)
  • hand weakness, scoliosis

🚩 Get help if…

  • call 112 / 911 now Trouble swallowing or breathing, or pauses in breathing during sleep
  • call 112 / 911 now New weakness of arms or legs, or loss of bladder control
  • see a doctor soon Back-of-head headache on coughing or straining
  • see a doctor soon Numb hands or burns you did not feel

Where it strikes

Medical treatment

  • MRI of brain and spine
  • watch without surgery if there are no symptoms
  • posterior fossa decompression for symptoms or a growing syrinx
  • shunting of the syrinx, rarely
  • headache treatment

Natural & lifestyle

  • Avoid heavy straining when symptomatic
  • physiotherapy

Emerging & experimental

  • Less invasive decompression without opening the dura
  • CSF-flow MRI to choose who needs surgery

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Chiropractic manipulation — untested; many surgeons advise against it anecdotal / traditional
  • Craniosacral therapy — no evidence anecdotal / traditional

ICD codes