Chiari Malformations

Question 1

what are they?

Answer 1

malformations of the hindbrain affecting the structural relationships between the cerebellum, medulla and upper cervical spinal cord which causes impaired CSF circulation through the foramen magnum.

Question 2

most common and least severe type?

Answer 2

type 1

Question 3

type 1 =

Answer 3

caudal displacement of cerebellar tonsils below formaen magnum

Question 4

least common and most severe type?

Answer 4

type 2

Question 5

features of type 1

Answer 5

headache
downbeat nystagmus
ataxic gait
Syringomyelia ‘cape like’ sensory loss of pain and temperature and progressive spastic paralysis starting with the upper extremities

Question 6

type 2 =

Answer 6

Arnold -Chiari

Caudal displacement of the cerebellum and medulla below the foramen magnum and herniation of fourth ventricle

Question 7

type 2 features?

Answer 7

severe brainstem dysfunction (dysphagia, apnoea, stridor and nystagmus)
weakness that may progress to quadriplegia
association with syringomyelia, spina bifida, and hydrocephalus

Question 8

surgical treatment of Chiari malformation

Answer 8

Suboccipital craniectomy + upper cervical laminectomy (relieves pressure and restores flow of spinal fluid)

Question 9

What is syringomyelia?

Answer 9

expanding cystic cavity or syrinx forming in the spinal cord that can cause damage to the central spinal cord