chiari malformation is a condition where the lower part of the brain pushes down into the spinal cord. sometimes its asymptomatic , but late childhood and teenage can show symptoms
surgical treatment can treat headaches, fluid accumalation in the cavities deep in the brain and nerve compression whereas the physiotherapy can treat pain management, balance problems, muscle problems, vestibular issues and gait training.
so what is chiari malformation ?
it is a condtion where the lower part of the brain pushes down into the spinal cord causing the nervous system disruption.
there are four types of chiari malformation which was classified by the damage to the nerves and tissues.
type 1s are asymptomatic where as type 4 is extremely rare and fatal.
symptoms of chiari 1 malformation
chiari 1 malformation can be diagnosed as an incidental finding through MRI imaging. but some individiual will have sumptoms depending on the extend of the damage to the tissues and nerves.
some of the symptoms are :
- Headache
- Neck pain
- Balance difficulties
- muscle weakness
- sensory changes in arms
- vomiting
- dizziness
- scoliosis
Chiari Decompression Surgery
Surgical Chiari malformation treatment aims to decrease pressure on the brain and spinal cord to lesson or eliminate symptoms. The standard surgical intervention is a posterior fossa decompression where a small portion of the back of the skull is removed (craniectomy).
Depending on the extent of symptoms and malformation, surgery may also include removal of the bony part of the spinal column (laminectomy), and/or cauterization of the cerebellar tonsils.
Physiotherapy for Chiari 1 malformation :
streatiching – pressure on nerves often leads to tightening of muscles as children grow muscles become even tighter to accomodate for bone growth
stregthening – compression of nerves can cause muscle weakness and imbalances
Balance training – sensory nerves can also be compromised leading to decreased sensation in the legs and geet leading to balance difficulties
pain management techniques – use of manual therapy and soft tissues techniques to help manage headches and bacck pain that may accompany scoliosis
vestibular rehabilitation therapy – vestibular techniques can help resolve some of the audio vestibular symptoms including dizziness, nystagmus.