General Information
CM is a clinical syndrome which has resulted from a variable decent of part of the brain called cerebellar tonsils through the hole at the base of the skull, foramen magnum, that transmit the the spinal cord to spinal canal. As a result, there will be pressure at the upper part of the spinal cord, cranio-cervical junction, which may lead to various complications like building up the pressure of the cerebrospinal fluid in the brain, or in the spinal cord leading to a condition called syrinx, where the fluid build up in cavity within the substances of the spinal canal.
The severity of the condition can vary from person to person. clinical features can vary depending on the extent of the problem and whether the condition associated with hydrocephalus and/or spinal syrinx. it’s varies from a simple headache to very severe weakness of the limbs. A headache is a very common symptom, usually at the back of head, aggravated when the patient lough, strain or cough, associated with blurring of vision, tingling of the upper limbs and face. Other symptoms include: double vision, swallowing problem, balance problem etc.
Diagnosis investigations like MRI scan of brain and spinal cord, sometimes an intracranial pressure monitoring is necessary to exclude underlying cause of the condition.
Treatment is usually surgical. The most common surgical approach is called suboccipital decompression or craniocervical decompression. Sometimes even with decompression, the syrix need further treatment with syringoperitoneal shunt. Hydrocephalus should be treated with VP shunt as initial step in the management is the investigation confirm it.
Chiari 1 without a complicated Syrinx
