Chiari Malformation Surgery

Chiari malformation, also referred to as the Arnold-chiari malformation or cerebellomedullary malformation syndrome, is a medical condition characterized by the protrusion of brain tissues into the spinal canal.

It generally occurs when a part of the skull, either small or abnormally shaped, presses into the brain and forces it downwards, which, in turn, disrupts the flow of cerebrospinal fluid, i.e., the fluid meant to protect the brain and spinal cord.

This either hampers the signal transmission between the brain and body, or leads to build up of fluid in the brain. In either case, it is harmful for the body.

The treatment of this condition includes regular monitoring, medication, and surgery, depending on a range of factors, including the form of the ailment, its severity, and the symptoms associated with it. In some cases, treatment is not needed at all.

At times, the person may not even realize that he is suffering from this disorder, unless the symptoms become severe. The surgical method of treatment is most often used to treat symptomatic chiari malformation.

Chiari malformation is basically divided into 2 types: chiari malformation type I, which develops as the body grows, and chiari malformation type II, which is congenital (meaning present at birth).

In case of chiari type I, the malformation is caused due to abnormal size of the skull, whereas chiari II―the pediatric form of malformation―can be attributed to an underlying medical condition referred to as myelomeningocele.

The surgery is targeted at stopping the progression of anatomical changes in the brain and spinal canal. In posterior fossa craniectomy (A.K.A. posterior fossa decompression), a small portion of the bone at the back of the skull is removed to create more space for the brain.

Subsequently, the dura (i.e., the brain covering) is opened and a new patch is sewn into it to make it bigger and provide more room for the brain. The material used as a 'patch' may be an artificial material or a tissue harvested from the neck or leg.

Other than easing the symptoms of the condition, the surgery also reduces the pressure on the cerebellum and spinal cord, and simultaneously restores the flow of spinal fluid.

Any surgery in this part of the body has several risks associated with it, chiari malformation surgery is no exception. Risks involved in this case include excessive bleeding, cerebrospinal fluid leak, anesthesia complications, and paralysis.

The person may also experience problems in swallowing and abnormal eye movements. The chances of infection also persist and hence, the person has to keep himself updated about the prognosis and development.

The recovery period may vary from individual to individual depending on several factors. One has to weigh the possible benefits and risks, and consult the doctor to check whether this surgery is the best alternative for him. On an average, the surgery itself is completed in 2 to 3 hours and the person is hospitalized for 2 to 4 days.

The cost incurred will vary depending on the severity of the condition, hospital chosen, etc. Regular checkups and symptom monitoring will help in tracking the healing procedure in the patient and abiding by the advice given by the doctor will ensure speedy recovery.