Chiari Malformations

With Chiari malformations, brain tissue extends into the spinal cord and interferes with the circulation of cerebrospinal fluid. This can occur when the cavity near the base of the skull is abnormally small, so the lower part of the brain (cerebellum) gets pushed downward.

When determining the approach to treat these conditions, it’s crucial to first pinpoint what type it is and what symptoms a patient is experiencing. The three main categories of Chiari malformations are: 

  • Type I, the most common, is usually congenital (present at birth), though acquired cases are possible, and the defect generally isn’t obvious at birth. It may not cause any symptoms and often goes unrecognized until adolescence or adulthood.
  • Type II is more severe and usually is noticed during childhood.
  • Type III is extremely rare and is apparent during infancy.

Many people with the most common type of Chiari malformation won’t experience symptoms, and the malformation will be discovered incidentally. If symptoms do occur, severe headache and neck pain are the most common.

Why Choose UT Southwestern?

For most patients, we recommend monitoring the condition. However, if the Chiari malformation poses a significant threat to a patient’s health or if symptoms interfere with someone’s quality of life, we offer comprehensive perspectives and treatment options.

If surgery is the recommended treatment, it’s important to see a group of specialists who knows when it’s appropriate to operate and when it’s not. Some groups elsewhere will operate based solely on an imaging diagnosis. At UT Southwestern, we evaluate your imaging studies, which are gathered following our specific protocols so we get exactly what we need, and we match what we see to your symptoms to determine the severity of the Chiari malformation.

Other institutions refer their rarest cases to us because we offer a team of Chiari malformation specialists. When you see one of us, you’re effectively seeing the whole team – we discuss your case in our team meeting of neurosurgeons, neurologists, neuroradiologists, and others to come up with the best treatment strategy for your specific situation, and all our team members are available when needed.

Symptoms

Along with headaches and neck pain, other symptoms of Chiari malformations can include dizziness, vertigo, disequilibrium, visual disturbances, ringing in the ears, difficulty swallowing, palpitations, sleep apnea, muscle weakness, impaired fine motor skills, chronic fatigue, and painful tingling of the hands and feet.

Because of this complex range of symptoms, Chiari malformations can be difficult to diagnose when physicians aren’t familiar with them. People with Chiari malformations often also have hydrocephalus, syringomyella, and tethered cord syndrome.

Our Services

If you’ve had an MRI and your doctor thinks you might have a Chiari malformation, make an appointment to visit UT Southwestern.

Bring your imaging studies to your first appointment, but keep in mind our neuroradiologists may want to perform additional imaging studies. It’s important that we get the exact images we need and talk with you about your symptoms and medical history before we diagnose a Chiari malformation or set up a treatment plan.

Once we’ve evaluated you and made a diagnosis, treatment may include observation with surveillance imaging over time (if you’re not experiencing symptoms), or surgery if your Chiari malformation is causing symptoms.

Surgical options include foramen magnum decompression and placement of a shunt to drain excessive cerebrospinal fluid.

After your initial treatment, we offer a dedicated neurocritical care unit (neuro ICU), as well as neurorehabilitation services, all in the same building.

Request an Appointment

To schedule an appointment with a Chiari malformation specialist at UT Southwestern’s facilities in Dallas, or to learn more about our services, request an appointment or call 214-645-8300.