MRI results

[nurseling07]

Just an update and a few questions... I was dx with Chiari in 2005 and had a 5mm herniation. I have having the chiari headaches, dizziness, nausea, etc that caused me to go to the dr then when I found out I had Chiari. I saw a NS and decided not to go back (he mentioned decompression and it scared me so I decided to just deal with the symptoms versus brain surgery).....Fast forward to last month- I have been having multiple problems daily with position changes, headaches, etc. I've also noticed problems swallowing liquids (no getting choked per say but having to hold and swallow again to keep from choking), flushing, and my hands and feet seem to "go to sleep" often. I went back to my NS who then ordered an MRI of brain and cervical spine with and without contrast. My ins limits me on who I can go to (I work at said hospital thus I must use their district in order for them to cover services 100%). I got a copy of my results and it says my herniation is 9mm, no syrinx and bulging disc at c5-6. He never mentioned a cine MRI (and my research on the topic says not all NS prove it to be useful). I have asked multiple people who work with him and they all tell me he is great. I go back in two wks for him to discuss results and decompression. The increased herniation given the increased symptoms worry me ( and a physician that I work with said if left untreated I could develop irreversible damage including paralysis). Just looking for some input from the pros regarding the herniation, should I consider surgery this time around given it was offered 7 yrs ago and I refused, and can the swallowing and bulging disc be as a result of the Chiari?

[nurseling07]

I guess I could have added no Ehlers-Danlos, my T spine was clear and I have a bulging disc in my L spine from moving furniture last winter....but no syrinx.  

[selmaS]

  Hi....I would ask for more testing , check for Ehlers-Danlos as that could be the reason for the disk bulging and as for the length of the herniation it all depends on if it is creating a CSF obstruction or if u have overcrowding(retroflexed odontoid) that matters more then how long the herniation is. A CINE MRI would be a good idea as would a MRI of the thoracic and lumbar spine to rule out a syrinx in those areas as well, many Drs do not look there but those with Chiari can have them ne where in the spine.

Yes, the swallowing issues could be chiari related, and many with Chiari r also prone to autoimmune issues like Hashimoto's thyroiditis which can also cause issues with swallowing.

Lastly if the new MRI was done with Diff slices it can appear that the herniation grew, when in fact it is the same size as b4...it all depends on the angles and slices and if done by the same machine, magnification...even some Drs place of measuring differes.....so, it is helpful to have a consult with a true Chiari specialist...I know u said u work at a hospital and to get 100% coverage u have to go thru them, but it is well worth it to go with a well experienced Dr when it comes to this.

U will want to know if u have ne of the related issues b4 u consider surgery as that can affect how u feel and heal post op......not everyone with chiari is a surgical candidate.

Get a few opinions.