What is Arnold Chiari?
It is the herniation of the lowest extensions of the cerebellum, called tonsils, from the opening at the skull base (foramen magnum) towards the spinal canal. The herniated tissue affects the circulation of the cerebrospinal fluid and causes complaints. As a result, cerebrospinal fluid may accumulate in the brain (hydrocephalus) or spinal cord (syringomyelia).
Type 1: It is the compression of the cerebellum that occurs as a result of the small back of the head. This condition can be observed in both adults and children. It is the most common type of Arnold Chiari Syndrome and can cause a cyst in the spinal cord.
Type 2: It occurs during birth and especially affects babies. It occurs together with spina bifida, which is a spinal cord anomaly. If the spine does not close before birth, it is the situation where the spinal cord protrudes like a sac in the part that does not close.
Type 3: It is rare and mostly occurs in infants with the formation of a fluid sac at the back of the baby's neck. This is a birth defect called an encephalocele.
Type 4: It occurs when the cerebellum does not develop properly in babies.
What Are the Symptoms of Arnold Chiari Syndrome?
Symptoms in adults can be listed as follows:
Neck pain Dizziness Dizziness Numbness in the hands and feet Difficulty in swallowing Hearing loss, ringing in the ears Loss of sensation in the trunk and head region Curvature of the spine Loss of balance
Symptoms in infants can be listed as follows:
Eating problem Swallowing problem Belching, vomiting Irregular breathing Slowing of body development Weakness in arms Enlargement in head Epileptic attacks Nervousness
How Is Arnold Chiari Disease Treated?
Treatment differs according to the type, severity and symptoms of sagging. Some medications can be prescribed for mild pain that does not affect daily life much. Surgical treatment is required if the disease causes severe symptoms or damages nerve tissues. The type and number of surgeries needed depend on the patient's condition. Brain prolapse surgery in adults is performed by cutting out part of the skull bone. The exposed part of the brain is then covered with tissue taken from another part of the body. This process creates more room for the cerebellum and brain stem, relieving the pressure on the spine. If needed during the surgery, the cerebellum tonsils are reduced using electric current. It may also be necessary to remove a small portion of the spine to provide more space. Congenital defects such as spina bifida and encephalocele that accompany cerebellum prolapse are treated with surgery for infants and children. Surgery is done to reposition the spinal cord and close openings in the neck or back. If there is hydrocephalus, a tube is inserted to drain excess fluid from the brain to reduce intracranial pressure. Surgery is performed to alleviate the severity of symptoms.