Chiari I Malformation Surgery

Chiari malformation is when the “cerebellar tonsils” in the back part of the brain extend down into the spinal canal. This may change the normal flow of cerebral spinal fluid as it moves from the brain and down the spinal cord. Some people have a spinal cord cyst (an abnormal collection of fluid). This cyst is called a “syrinx.” This syrinx may also cause symptoms.

Common Symptoms

• Headaches

• Neck, shoulder or arm pain

• Weakness or changes in the feeling in your hands, arms, or legs

• Symptoms that become worse with straining or coughing
  

Treatment
Your doctor may suggest surgery to make room for the cerebellar tonsils. Surgery often improves the symptoms or keeps them from getting worse.

Your neurosurgeon will decide the best method of surgery and will go over this during a clinic visit.

After surgery, the normal flow of cerebral spinal fluid (CSF) is restored. Often, the spinal cord cyst will go away in a few weeks or months.

Before Surgery
You will need an exam and lab tests before surgery. Schedule this exam with your primary care provider or with a nurse in our department. Complete this within 30 days of surgery. We may cancel surgery without this exam. Contact your insurance company for any referrals you may need.

Stop these medicines for two weeks before surgery:

• Aspirin, Excedrin®, Ascriptin®, and Ecotrin®

• Vitamins and herbal supplements

• Plavix®

• Coumadin® or Warfarin

• Ibuprofen, Advil®, Motrin®, Nuprin®, and Aleve®
  

You may use acetaminophen (Tylenol®), if needed.

Avoid smoking and cigarette smoke for two weeks before surgery. Smoking delays wound healing. Cigarette smoke contains a poison that lowers the level of oxygen in the blood.

You will be called the afternoon before surgery. The nurses will tell you what time you need to arrive and will give you final details about getting ready.

You will sign a consent form that states you understand what was explained to you about the procedure. It also states that you know about the risks and benefits of the surgery.

Surgery
This surgery may take 3-5 hours. An incision is made from the middle of the neck to the back of your head.

After Surgery
Avoid coughing, lifting, and straining for the next 3 months. You and your doctor will decide when you should return to school or work.

When to Call
Call if you have any of these symptoms:

• Severe headache

• Fever over 101.5° F

• Redness, swelling or drainage at the incision site

• Nausea or vomiting
  

Who to Call
Pediatric Neurosurgery Clinic
(608) 263-6420

After hours, nights, and weekend, call the paging operator at (608) 262-0486. Ask for the neurosurgeon on call. Leave your name and phone number with the area code. The doctor will call you back.