Aa
Chiari Malformation
So Long Story short I had the decompression surgery Dec. 2012, the surgeon did the craniectomy and scored the dura instead of doing the patch. His original plan was the craniectomy, patch, and laminectomy. I started having symptoms coming back in September, neck pain is worse with the base of skull head aches. I had an MRI today and the reading states "there is adequate flow to anterior to the medulla. The cerebellar tonsils remain low lying but there is CSF space posterior to them although no pulsatile CSF flow at the posterior craniocervical junctions. Can have someone give me some information in layman's terms. Does this possibly mean surgery again?
I have been complaining of wrist and hand weakness for a while, along with weird episodes during the night with my arm. This sounds like I should be a bit concerned.
I have been complaining of wrist and hand weakness for a while, along with weird episodes during the night with my arm. This sounds like I should be a bit concerned.
MEDICAL PROFESSIONAL
Hi!
I do appreciate your concerns about the MRI finding because there is reason to worry.
Normally, the CSF flows ventricles into the subarachnoid space (space between the brain and skull) and into the spinal canal. This happens in a rhythmic pulsatile manner. When there is blockage of the hole between skull and spinal canal (foramen magnum), there CSF flow is obstructed and it pushes with force into the spinal canal causing further heniation of the cerebellar tonsil.
In your case the pulsatile CSF flow is not seen indicating that there is still some blockage. The CSF that cannot flow out can form a collection into the spinal canal (syrinx) or in the ventricles (hydrocephalus). In your case, this hasn’t yet developed.
A posterior fossa CSF space can be an arachnoid cyst, epidermoid cyst or a mega cisterna magna. The block to CSF flow could be due to the posterior fossa CSF space causing pressure on the cerebellum.
Sometimes you need revised surgery. Sometimes, the symptoms can be managed with medications. Please discuss with your doctor.
Hope you get well soon! Good Luck and take care!
I do appreciate your concerns about the MRI finding because there is reason to worry.
Normally, the CSF flows ventricles into the subarachnoid space (space between the brain and skull) and into the spinal canal. This happens in a rhythmic pulsatile manner. When there is blockage of the hole between skull and spinal canal (foramen magnum), there CSF flow is obstructed and it pushes with force into the spinal canal causing further heniation of the cerebellar tonsil.
In your case the pulsatile CSF flow is not seen indicating that there is still some blockage. The CSF that cannot flow out can form a collection into the spinal canal (syrinx) or in the ventricles (hydrocephalus). In your case, this hasn’t yet developed.
A posterior fossa CSF space can be an arachnoid cyst, epidermoid cyst or a mega cisterna magna. The block to CSF flow could be due to the posterior fossa CSF space causing pressure on the cerebellum.
Sometimes you need revised surgery. Sometimes, the symptoms can be managed with medications. Please discuss with your doctor.
Hope you get well soon! Good Luck and take care!
You mentioned that the CSF space could be 1 of the 3 things you mentioned above. Could it be anything else or typically it would call under one of three things? If a report notes what was found on my study is that abnormal as far as the CSF space? thank you for you time
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