The Epilepsy Institute of New Jersey is a team of board-certified neurologists and neurosurgeons who provide expert care for a variety of pediatric neurological conditions, including Chiari malformation. Our team uses advanced diagnostic tools and innovative treatment techniques to ensure the best outcomes for your child.
The Physical Impact
Chiari malformation is a structural defect in the skull and cerebellum, the part of the brain that controls balance. In this condition, part of the cerebellum (the cerebellar tonsils) extends downward into the spinal canal, which can put pressure on the brainstem and spinal cord. This abnormal positioning may block the normal flow of spinal fluid, potentially causing headaches, dizziness, and other neurological symptoms.
How Common Is This Condition?
Chiari malformations are relatively uncommon, but improved imaging technology has led to more frequent diagnoses in recent years. While Chiari malformation can occur in both children and adults, many cases are congenital, meaning they are present at birth.
Risk Factors:
- Congenital skull and brain structure differences
- Certain genetic conditions or family history
- Associated spinal abnormalities, such as tethered cord or scoliosis
Signs and Symptoms
Symptoms of Chiari malformation can vary depending on its severity and whether it impedes the flow of spinal fluid. Common signs include:
- Headaches, often worsened by coughing or straining
- Neck pain
- Balance and coordination difficulties
- Dizziness or vertigo
- Numbness or tingling in the hands or feet
- Difficulty swallowing or gagging reflex problems
- Hearing or vision disturbances
How We Diagnose
At the Epilepsy Institute of New Jersey, diagnosing Chiari malformation involves a thorough review of your child's medical history, symptoms, and physical examination findings. Advanced imaging techniques help confirm the diagnosis and guide the treatment approach. Key diagnostic tools include:
- MRI (Magnetic Resonance Imaging): Provides detailed images of the brain and spinal cord, revealing the position of the cerebellar tonsils.
- Cine MRI (CSF Flow Study): Evaluates the flow of cerebrospinal fluid around the brain and spinal cord.
- Neurological Evaluation: Assesses motor function, balance, coordination, and sensory changes.
This comprehensive evaluation allows us to determine the severity of the Chiari malformation and develop a personalized treatment plan.
Treatment Options
Treatment for Chiari malformation depends on the severity of symptoms and the degree of brainstem or spinal cord compression. Options include:
- Observation: In mild, asymptomatic cases, regular monitoring may be sufficient.
- Medications: To manage symptoms such as headaches or pain.
- Surgery (Posterior Fossa Decompression): A procedure to remove a small section of bone at the back of the skull, relieving pressure and restoring normal CSF flow.
- Additional Procedures: In some cases, treating associated conditions like tethered cord or syringomyelia (cyst formation in the spinal cord) may improve symptoms.
The Epilepsy Institute of New Jersey uses the latest surgical techniques, imaging guidance, and a multidisciplinary approach to ensure your child receives the safest and most effective treatment.
Our Commitment to Your Child's Health
“I am neurosurgeon living in New Jersey, board-certified by both the American Board of Neurosurgery (ABNS) and Pediatric Neurosurgery (ABPNS). I specialize in the surgical treatment of complex epilepsy and serve as the Director of the Epilepsy Institute of New Jersey, Chief of Pediatric Epilepsy Surgery at Sanzari Children's Hospital, and Chief of Pediatric Neurosurgery at Children's Hospital of NJ, where I provide exceptional care for children with complex neurological conditions. Your child's health and well-being are our top priorities.”
