Chiari Malformation

Chiari malformation is a structural defect where brain tissue extends into the spinal canal. This condition occurs when the skull is abnormally small or misshapen, causing part of the cerebellum—which controls balance—to press into the upper spinal column.

Chiari malformation affects roughly 1 in 1,000 people in the U.S., though many cases go undiagnosed due to subtle or overlapping symptoms. It can lead to headaches, balance problems, vision disturbances, and—in more serious cases—spinal cord damage.

At Cooper and Inspira Neuroscience, our neurological and neurosurgical experts specialize in diagnosing and treating Chiari malformation using advanced imaging, personalized care plans, and when needed, minimally invasive surgery.

What Is Chiari Malformation?

Chiari malformation refers to a group of structural defects at the base of the skull where the cerebellum meets the spinal canal. The most common type is Chiari I malformation, where the lower part of the cerebellum (the tonsils) pushes down into the spinal canal.

Common symptoms include:

• Headaches, especially after coughing or sneezing.
• Dizziness or vertigo.
• Balance or coordination issues.
• Neck pain.
• Muscle weakness or numbness.
• Difficulty swallowing.
• Vision problems.

Potential complications include:

• Syringomyelia (fluid-filled cyst in the spinal cord).
• Hydrocephalus (buildup of fluid in the brain).
• Chronic pain.
• Neurological decline.

Causes and Risk Factors

Causes

Congenital (present at birth): due to underdeveloped skull or neural tube defects.

Acquired: secondary to injury, infection, or spinal fluid abnormalities.

Risk Factors

• Family history of congenital neurological conditions.
• Spina bifida or other developmental brain/spine disorders.
• Conditions affecting cerebrospinal fluid (CSF) flow.

How We Diagnose Chiari Malformation

Accurate diagnosis starts with a detailed clinical exam and imaging studies. At Cooper, we use:

• MRI of the brain and spine.
• CSF flow studies (cine MRI).
• Neurological and functional testing.
• We also assess for related conditions like syringomyelia, hydrocephalus, and tethered cord syndrome.

Treatment Options for Chiari Malformation

Not all cases require surgery. Treatment depends on symptom severity and neurological risk.

1. Observation and Monitoring: For mild or incidental cases without significant symptoms.
2. Medication: Pain management and symptom relief (e.g., for headaches or nerve pain).
3. Surgery: Posterior fossa decompression is the most common surgery for Chiari I malformation. It creates more space for the cerebellum, restores CSF flow, and relieves pressure.

Why Choose Cooper and Inspira Neuroscience for Chiari Malformation Care?

At Cooper, our Chiari Malformation Program delivers advanced, coordinated care with access to:

• Board-certified neurosurgeons and neurologists.
• Specialists in complex spine and brain disorders.
• High-resolution MRI and advanced CSF flow studies.
• Personalized surgical planning and follow-up care.
• Recognition as a leading academic medical center in South Jersey.