Chiari malformation is a structural defect in the brain where the cerebellum and medulla are displaced slightly downwards through the foramen magnum (the opening in the base of the skull where the brainstem forms into the spinal cord). This may be due to shortened growth of the posterior fossa, which in turn causes residual pressure to push the cerebellar tonsils towards the spinal column.
Symptoms of Chiari Malformation
The most common symptom incurred by this disorder is a severe headache, but may also include muscle weakness, nausea, fatigue, inability to balance, pain in the upper neck, and hearing problems. However, in some cases the patient may be asymptomatic.
Treatment for Chiari Malformation
If the patient is symptomatic, this disorder may be treated surgically in an effort to prevent further neurological decline. Typically, the posterior fossa is decompressed via removal of the lamina of the first (and possibly second and third) cervical vertebrae along with a piece of the occipital bone of the skull. This procedure decompresses the part of the brain at the foramen magnum and is called a suboccipital decompression. In addition, the dura mater that covers the brain and spinal cord is opened to further decompress the brain. The dural opening is then patched with synthetic or allograft material prior to closing. This is referred to as a duraplasty. The skull defect is also repaired prior to closing and is referred to as a cranioplasty.
At Princeton Neurological Surgery, Dr. Lipani is a board certified fellowship trained neurosurgeon in New Jersey and specialist in the treatment for Chiari malformation. Dr. Lipani treats patients from around the world as well as locally from Princeton, New Brunswick, Hopewell, Pennington and communities throughout Somerset, Middlesex, Ocean, Burlington, Monmouth and Mercer Counties for Chiari malformation. Dr. Lipani offers brain surgery approaches for Chiari malformation treatment, tailored to the needs of each patient. For state-of-the-art Chiari malformation treatment call or email us to schedule a consultation at our offices in Hamilton, New Jersey or Bridgewater, New Jersey!