Typically, when a head injury from trauma is suspected, a CT scan or MRI of the head and neck is ordered. Sometimes, an incidental finding can be revealed and you'll discover you had a condition that you were not previously aware of and, likely, had no symptoms of. It's important to understand that several conditions that are found incidentally may actually progressively worsen over time following trauma to the head.
One of the most common medical conditions that are found incidentally is the Chiari malformation. If you've had head and neck imaging and have been told of an incidental finding of Chiari 1 malformation, you likely have several questions about this condition. Here's what you need to know.
Chiari 1 Malformation
Chiari malformation is a condition in which the skull in the back of the head and at the base of the brain is not shaped correctly. This causes the cerebellum to not have enough room at the base of the brain. The cerebellum is the part of the brain that is responsible for regulating motor movements, maintaining balance, vision, and possibly other roles that researchers have yet to discover.
Without enough room for the cerebellum in the skull, the cerebellar tonsils (lowest part of the cerebellum) end up protruding downward towards and sometimes into the opening for the spinal cord, which is called the foramen magnum. This may block the flow of spinal fluid and/or put pressure on the brain stem.
If symptomatic, Chiari 1 malformation typically produces a painful pressure headache that starts at the back of the head and may radiate forward. These headaches typically worsen when you cough or sneeze or when you bend over. However, headaches are by far not the only symptom to watch for. Because of the involvement of the cerebellum, brain stem, spinal fluid, and spinal cord, nearly all bodily systems can be impacted with symptoms such as muscle weakness and numbness, dizziness, swallowing difficulties, tinnitus, vision problems, loss of control of bowel and bladder, chronic pain, and many other symptoms.
Should symptoms ever become problematic or life-threatening, decompression surgery may be necessary, which is done by a neurosurgeon. Upon the incidental finding of your Chiari 1 malformation, you should be referred to a neurosurgeon for evaluation. The neurosurgeon will assess your current condition and establish a baseline for you, should your Chiari 1 malformation become symptomatic at any point in the future.