Chiari Malformation (ACM)

Also known as Arnold Chiari Malformation, this is a benign structural problem affecting the cerebellum. Most children with these malformations who do not have spina bifida will have the form known as Type I. Essentially there is extra cerebellum crowding the outlet of the brainstem/spinal cord from the skull on its way to the spinal canal. This crowding will commonly lead to headaches, neck pain, funny feelings in the arms and/or legs, stiffness, and less often will cause difficulties with swallowing or gagging. Often the symptoms are made worse with straining. When the diagnosis is suspected the study of choice is an MRI scan. These malformations are very difficult to see on CT scans and impossible to see on plain x-rays. Sometimes these malformations can be made worse by, or can cause hydrocephalus. In addition they can often lead to fluid filled cavities in the spinal cord known as syrinxes (also known as syringohydromyelia sear-IN-go-my-EEL-ya).

In general the symptoms of the Type I malformations are less severe than that of the Type II malformation. Untreated, the chronic crowding of the brainstem and spinal cord can lead to very serious consequences including paralysis. In addition they can lead to the development of syrinxes which may further injure the child's spinal cord and function.

 There are many ways to treat Chiari malformations, but all require surgery. The basic operation is one of uncrowding the area at the base of the cerebellum where it is pushing against the brainstem and spinal cord. This is done by removing a small portion of bone at the base of the skull deep to the neck muscles as well as often removing a part of the back of the first and occasionally additional spinal column segments. The operation is often modified if there is a syrinx present or if the child has hydrocephalus. Most children who have the surgery do quite well and have an improvement in their symptoms.
Credit for information above was taken from the: SPINA BIFIDA AND HYDROCEPHALUS ASSOCIATION OF NOVA SCOTIA CAPE BRETON CHAPTER

Want to read more about ACM? Check here-

Pediatric Neurosurgery-Columbia-Presbyterian Medical Center in New York City

Pediatric Neurosurgery INN New York

World Arnold Chiari Malformation Association-Support group w/ information

Chiari Malformation e-mail support group

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Need more information on Syrinx:

Syrinx (also known as syringohydromyelia sear-IN-go-my-EEL-ya)

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