Chiari Malformation

Overview

Chiari malformation is a structural condition in which the lower part of the brain (the cerebellar tonsils) extends through the opening at the base of the skull and crowds the spinal canal. This can block normal cerebrospinal‑fluid flow, irritate the brainstem and, over time, damage the spinal cord.

At The Royal Buckinghamshire Hospital, Aylesbury you can access swift consultant‑led assessment, on‑site CT imaging, coordinated MRI at our sister site (The New Foscote Hospital) and tailored rehabilitation..

Why Early Diagnosis Matters — Future Health Risks

• Syringomyelia: a fluid‑filled cavity develops in the spinal cord, leading to numbness, weakness and chronic pain.
• Hydrocephalus: blocked fluid pathways raise brain pressure, risking headache, vomiting and visual loss.
• Sleep‑Disordered Breathing: brainstem compression may trigger sleep apnoea and daytime fatigue.
• Curvature Of The Spine: long‑standing syringomyelia can cause scoliosis, especially in teenagers.
• Permanent Nerve Damage: untreated pressure can leave lasting arm and leg weakness or balance problems.

Symptoms You Might Notice

• Occipital or pressure headaches, often worse when coughing, laughing or straining
• Neck pain and stiffness
• Dizziness, poor balance or vertigo
• Numbness, tingling or weakness in the arms and hands
• Blurred or double vision, light sensitivity or ringing in the ears
• Swallowing difficulty, hoarseness or sleep apnoea snoring
• Hand clumsiness, loss of temperature sensation or bowel/bladder changes (if syrinx present)

Common Causes And Risk Factors

• Congenital skull‑base anatomy present from birth
• Family history of Chiari malformation (rare but recognised)
• Connective‑tissue disorders such as Ehlers‑Danlos syndrome
• Female sex — population studies show a slight female predominance
• Previous lumbar shunt or rapid removal of cerebrospinal fluid

When To Seek Medical Advice

Book an urgent consultation if you experience:

• Headaches triggered by coughing, sneezing or bending over
• Progressive numbness, weakness or balance loss
• New bladder or bowel problems
• Unexplained scoliosis or rapid spinal‑curve progression

Early review helps prevent irreversible spinal‑cord damage and guides timely intervention.

How We Diagnose And Monitor Chiari Malformation

1. Consultant Neurology Assessment – detailed history, neurological examination and discussion of lifestyle goals in our Neurology Department.
2. On‑Site CT Head And Cervical Spine – high‑resolution scans in the CT Suite assess bony anatomy and identify hydrocephalus.
3. MRI Referral To The New Foscote Hospital – seamless transfer for cine‑flow MRI and spinal imaging when more detail is required.
4. Multidisciplinary Review – neurologists, radiologists, physiotherapists and visiting neurosurgeons meet weekly to refine your management plan.
5. Structured Surveillance – scheduled scans and neurological reviews track progression and syrinx size.

Treatment And Continuing Support

• Active Monitoring – repeat imaging and clinic review if symptoms are mild or absent.
• Prescription Pain Management – coordinated by our Pain‑Management team for headache and neck pain.
• Physiotherapy And Posture Coaching – core strength, balance and ergonomic advice through our Rehabilitation Service.
• Posterior Fossa Decompression Surgery – if symptoms progress or a syrinx enlarges, we arrange prompt referral to a regional neurosurgical centre, then provide pre‑ and post‑operative care back in Aylesbury.
• Managing Associated Conditions – sleep‑study referral for apnoea, scoliosis monitoring and hydrocephalus shunting where indicated.

Why Choose The Royal Buckinghamshire Hospital?

• Rapid CT imaging and neurology appointments, typically within one week
• Integrated pathway: diagnostics, pain therapy and rehabilitation under one roof
• Close collaboration with The New Foscote Hospital for advanced MRI and neurosurgical intervention
• Consultant‑delivered clinics with no junior‑led hand‑offs
• Private ensuite rooms, free on‑site parking and easy access from Oxford, Milton Keynes and London

Frequently Asked Questions

Is Every Chiari Malformation Operated On?
No. Many patients live symptom‑free and only need monitoring. Surgery is recommended when pain, neurological deficit or syringomyelia progresses.

What Does Decompression Surgery Involve?
A neurosurgeon removes a small section of bone at the skull base (and sometimes part of the first cervical vertebra) to create space and restore fluid flow. Most people spend two to three nights in hospital.

Will My Symptoms Come Back After Surgery?
Long‑term studies show durable relief in the majority of patients, but scar tissue can occasionally cause recurrence; regular follow‑up imaging helps catch this early.

Take The Pressure Off Your Brain

Phone 01296 678 800 or enquire online to book your Chiari‑malformation assessment and personalised care plan.