help with CSF flow study results

[Ldon32]

My son age 17 yrs old was diagnosed with chiari malformation in 1998 with a 22mm herniation. He was also diagnosed with occult hydrocephalus and T spine syrinx. He had decompression surgery with c1 c 2 laminectomy and placement of VP shunt. In 2009 he had increased occipital headaches and underwent a decompression again but this time they "cauterized" the cerebellar tonsils and informed me that post op MRI showed the cerebellar tonsils were back in the skull with no crowding at the foramen magnum.
For the past 3 weeks he has been complaining of constant occipital headache but it changes in intensity from a 2 to a 7 on the pain scale. The headache is unrelieved with advil or tylenol. He just spent 5 days in the hospital and had shunt exploration, shunt was working fine. They also did a trial of IV reglan and IV toradol with no change in headache. The NS discharged him and is unsure at this time if it chiari related.
The report is as follows as I am concerned he should have another decompression.


The study reads:
trace flow of cerebral spinal fluid anteriorly at the craniocervical junction. No flow is seen posteriorly. Minimal kinking of the brainstem and craniocervical junction with crowding of the foramen magnum by the cerebellar tonsils.
His NS is unsure at this time if his headaches are due to these findings. I feel they are as this is how his headaches presented in 2009. This is not the NS that did his decompression in 2009. Should I go for a 2nd opinion or is this normal finding 3 yrs post decompression?

[selmaS]

  No worries....I pray all is going well.

[Ldon32]

hello,
Thank you for your response and for removing the other post. I am new to this so didnt realize the first one posted :)
He had a shunt exploration yesterday and they said it was perfect.
The NS from 2009 did tell me it that the tonsils shrunk back with no obstruction.
It is so frustrating as we spent 5 days in the hospital, went through shunt exploration and tried 3 different IV meds with no response.
Of course reading the MRI report can scare anyone that doesnt quite understand it all.
Thanks again and I will ask those questions on Wednesday when we return for wound check.

[selmaS]

  Hi and welcome to the Chiari forum.

I hope u do not mind I had the other thread deleted as it is almost a dup of this one, but this one has more info that is important to a reply.

The kinking of the brain stem is an important factor as well as the trace flow of CSF..not sure if it is due to the shunt....

The fact the shunt is working does not mean it is not working to the best for ur DS...it may be drawing too  fast or too slow....

I would ask to have him checked for scar tissue, cervio cranial instability....and ehlers-danlos.

U mentioned that the tonsils were retracted back into the foreman magnum....I am shocked that just a cauterized tonsils would cause them to retract that far when they were herniated as far as u say....mine were only 4 and 6 mm's and  I had them cauterized and  they were still 2 mm's herniated....although I do have tethered cord.

U may want to find a Chiari specialist to review his reports and MRI.....