Chiari malformation is an uncommon medical condition where a part of the brain extends into the spinal canal. This bulge occurs at the back of the skull and pushes through a normal opening in the skull, resulting in pressure being placed on the spinal cord and parts of the brain. Chiari malformation is typically a congenital condition. Although it is an unusual condition, doctors are more able to commonly diagnose it due to increased use of imaging tests such as MRIs.
There are three types of Chiari malformation. Chiari malformation type 1 is typically symptomized by headaches which are often severe. These headaches often occur after sneezing, coughing, or straining. These headaches are typically located at the back of the head and neck and are often worsened by exertion. Those with Chiari malformation type 1 may also experience neck pain, an unsteady gait and problems with their balance, poor hand coordination, paresthesia (numbness and tingling) of the hands and feet, dizziness, difficulty swallowing, or speech problems. Less common symptoms include tinnitus (ringing in the ears), a slow heart rhythm, scoliosis due to spinal cord impairment, or breathing problems.
Chiari malformation type 2 occurs when the individual has a greater amount of brain tissue pushing into the spinal cord. Chiari malformation type 2 can be associated with hydrocephalus, a condition which occurs when there is an obstruction of cerebrospinal fluid (CSF) into the small ventricles of the brain. This results in a buildup of pressure in the head. Hydrocephalus may require surgical intervention by way of placement of a flexible tube (shunt) into the brain to drain the cerebrospinal fluid into another part of the body.
Some individuals with a Chiari malformation may also have a syrinx, which is a cyst, in the spinal cord. When the cyst fills with cerebrospinal fluid, it will expand and place pressure onto the spinal cord. Pressure on the spinal cord may result in numbness in the extremities, difficulty walking, difficulty breathing, or other types of neuromuscular dysfunction. Some individuals with a Chiari malformation also experience tethered cord syndrome. This condition occurs when the spinal cord attaches to the spine and causes the spinal cord to stretch. This may result in major nerve and muscle damage in the lower body.
To diagnose Chiari malformation, your doctor will order imaging tests to confirm the cause of your symptoms. MRIs are often used to detect a Chiari malformation. The MRI will provide 3D images of the structural differences of the brain as well as images of the cerebellum. Your doctor will be able to determine from viewing your MRI results whether there is brain tissue which is extending into the spinal canal. Your doctor may also order a CT scan. A CT scan can be used to determine if there are any brain tumors, damage to the brain, or problems with the bones and blood vessels.
Individuals with a Chiari malformation may also suffer from sleep apnea. Sleep apnea is a condition where you stop and start breathing during your sleep. Sleep apnea is diagnosed via a sleep study which will reveal how many “apneas” (pauses in your breathing lasting 10 seconds or more) that you experience in your sleep. Individuals with sleep apnea often experience severe fatigue during the day and have trouble staying awake during the workday.
Chiari malformation may be treated with surgery. The most common type of surgery is known as a posterior fossa decompression. In this type of surgery, the surgeon will remove a small section of bone in the back of the skull. By doing so, this will relief pressure in the brain as the brain tissue will have more room. Sometimes, the surgeon will open the covering of the brain, called the dura mater. The surgeon may also sew a patch into place to provide more room for the brain. The patch may be made of artificial materials, or it may be harvested from other parts of the body. The surgeon may also remove a small portion of the spinal column. This will allow more space for the spinal cord, thus relieving pressure on the spinal cord. In cases where the person has a syrinx or has hydrocephalus, it may be necessary to place a shunt to drain the excess fluid.
Chiari malformation is a serious condition, and its symptoms can greatly interfere with your activities of daily living and your ability to maintain employment. Surgeries such as posterior fossa decompression surgeries or shunt placement surgeries often require long inpatient hospitalizations with considerable post-surgical recovery time. This may cause you to be absent from work for extended periods of time. In addition, people with a Chiari malformation may have trouble with fine motor skills. This may interfere with your ability to perform jobs that require constant use of your hands, such as typing or handling small objects. Numbness and tingling in the upper extremities can also interfere with your ability to use your hands. People with Chiari malformations may experience muscle weakness, interfering with the amount of weight that they can lift and carry. Further, the severe headaches often associated with a Chiari malformation may cause you to need frequent breaks during the workday that are in excess of what your employer would typically allow, or may require you to call out sick on a regular basis. Finally, nerve damage resulting from a Chiari malformation may cause difficulty with walking and standing, especially for prolonged periods of time. A person with nerve damage due to Chiari malformation may also experience problems with his or her bladder and require more frequent bathroom breaks or access to a restroom.
If you are suffering from a Chiari malformation and are unable to work, you may be entitled to Social Security Disability benefits. Call the LaBovick Law Group at (561) 625-8400 for a free case evaluation. The legal team at LaBovick Law Group is experienced in understanding what factors the Social Security Administration considers when evaluating whether an individual is entitled to disability benefits, and will build the strongest case for your approval.