Chiari malformation or sagging cerebellum is a condition where the cerebellum sags down into the canal from the opening to the spinal cord, located at the nape of the neck, also known as the foramen magnum. When the cerebellum begins to enter the canal where the spinal cord is located, it may produce different symptoms due to the resulting compression. Especially when coughing and sneezing, the pain on the back of the head may increase and visual impairment, difficulty in swallowing and other symptoms may be seen. Although it is often congenital, it may cause complaints in patients of different ages.
Severe pain on the back of the head, especially when coughing and sneezing, is frequently seen. The sagging cerebellum can cause loss of strength in the arms and legs due to the compression of the spinal cord and the brain stem. There may also be a tingling sensation, numbness in the arms and hands due to a similar mechanism. Difficulty in swallowing, visual impairment, crossing in the eyes, balance disorders, findings of hydrocephalus, severe headache, nausea and vomiting, mental fog, seizures etc. may be encountered.
Magnetic Resonance Imaging (MRI) is performed for diagnosis. As Chiari malformation causes the formation of cysts in different parts of the spinal cord, it may be necessary to perform an MRI on the neck, back, and waist regions.
Only patients with non-severe headaches can be monitored. Otherwise, surgery is the only option for treatment. In this case, it may be necessary to remove the posterior part of the bone that covers the posterior cavity of the head and the posterior part of the first cervical vertebra to alleviate the sagging and compressed cerebellum. It may be necessary to insert a shunt for patients who have hydrocephalus.
