Chiari malformation or sagging of the cerebellum is the sagging of the cerebellum, which hangs down into the canal from the opening in the neck to the spinal canal in the nape of the neck, also called as the foramen magnum. When the cerebellum begins to enter the spinal cord, it may give different symptoms by squeezing. Especially when coughing and sneezing, pain which is on the back of the head may increase and visual impairment, deglutition disorders and other symptoms may be seen. Although it is often congenital, it may cause complaints in patients of different ages.
Symptoms: Especially when coughing and sneezing, pain which is on the back of the head is frequent. The sagging cerebellum can cause loss of strength in the arms and legs by compressing to the spinal cord and the brain stem. There may also be tingling, numbness in the arms and hands, with a similar mechanism. Difficulty in swallowing, visual impairments, crossing in the eyes, balance disorder, symptoms of hydrocephalus, severe headache, nausea and vomiting, mental fog, seizures, etc. may be seen.
Diagnosis: Magnetic Resonance Imaging (MRI) is performed and diagnosed. As Chiari malformation causes the formation of cysts in different parts of the spinal cord, there may need to perform an MRI on the neck, back, and lumbar region.
Treatment: Only patients with non-significant headaches can be followed up. Surgery is the only option in the treatment. In this case, it may be necessary to take the back part of the bone that covers the posterior pit of the head and the back part of the first neck spine to relieve hanging and squeezed cerebellum. It may be necessary to place a shunt to the patients who have hydrocephalus.