Dr.Öğr.Üyesi Gökhan GÖKÇE – Beyin, Sinir ve Omurga Cerrahisi Uzmanı

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Chiari malformation, or prolapse of the cerebellum, is defined as a prolapse of the cerebellum downwards from its normal position and is usually a congenital condition.In this case, the prolapse of the cerebellum occurs towards the spinal canal in the nape of the neck, which can cause compression.The symptoms and treatment of Chiari malformation are as follows:Symptoms:1. Severe Headaches: Headaches are common, especially during coughing, sneezing or strenuous physical activities.These headaches may be at the back of the head and may have migraine-like characteristics.

2. Neurological Symptoms:Neurological symptoms may develop as a result of the cerebellum pressing on the spinal cord or brain stem. These symptoms may include weakness in the arms and legs, numbness, tingling, impaired balance, coordination difficulties, difficulty swallowing and vision problems.

3. Hydrocephalus: Chiari malformation can sometimes lead to hydrocephalus.Hydrocephalus is characterised by fluid accumulation in the brain ventricles as a result of impaired normal circulation of cerebrospinal fluid. In this case, symptoms of hydrocephalus may also be observed.

Diagnosis:Chiari malformation is diagnosed by Magnetic Resonance Imaging (MRI).MRI is used to visualise the prolapse and compression of the cerebellum. It can also be performed to detect other findings associated with Chiari malformation and hydrocephalus.

Treatment of Chiari malformation usually involves surgical intervention. The aim of treatment is to reduce the compression of the cerebellum on the spinal canal. During surgery, the bone covering the posterior cavity of the head and the posterior part of the first cervical spine bone can be removed.This can help return the cerebellum to its normal position and relieve the compression.If hydrocephalus is present or has developed, shunt surgery may also be required to manage the cerebrospinal fluid.This procedure helps to remove excess fluid from the brain.

The choice of treatment is determined depending on the patient’s symptoms, the severity of the Chiari malformation and other individual factors. After treatment, regular follow-up of patients is important, as sometimes symptoms do not improve or recur after surgery.

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