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Treating Chiari malformations in children

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Pediatric Chiari malformations treatment at Geisinger

Chiari malformations occur in an estimated 1 in every 1,000 children born. Whether you’re looking for a second opinion or an evaluation for Chiari malformations treatment, our pediatric neurosurgery team is dedicated to determining the best path of care customized to your child’s needs.

Chiari malformation (pronounced key-AR-ee mal-fore-MAY-shun) occurs when brain tissue extends into the spinal canal. It can occur when a child’s skull is abnormally small or misshapen, which causes the skull to put pressure on the brain and force it downward.

This disorder affects the cerebellum (the bottom of the brain), which controls balance, and is more common in girls than in boys. This part of the brain normally sits above an opening in the skull where the spinal cord passes through. Chiari malformations (CM) are categorized into four main types: 

  • Type I is the most common type of CM and occurs when the lower part of the cerebellum extends into the hole at the base of the skull (called the foramen magnum). With Type I CM, symptoms may not occur until later in life. If part of the brainstem is pushed downwards, it is considered Type 1.5 CM.
  • Type II sometimes called “classic CM,” occurs when both the cerebellum and brain stem tissue extend into the foramen magnum. It is usually accompanied by myelomeningocele, a form of spina bifida.
  • Type III is a rare, severe form of CM when the cerebellum  and sometimes the brainstem  stick out through an abnormal opening in the back of the skull. 
  • Type IV occurs when an incomplete or underdeveloped cerebellum is in its normal position. 

When Chiari malformations are present, pressure on the cerebellum and brain stem can influence your child’s everyday functions.

What are the signs and symptoms of Chiari malformations?

Chiari malformations are often responsible for headaches, especially ones that follow sudden coughing, sneezing or straining. While symptoms aren’t always present, if your child is suffering from Chiari malformations he or she may experience: 

  • Difficulty swallowing or speaking 
  • Dizziness 
  • Hearing or balance problems
  • Insomnia
  • Neck pain
  • Trouble with fine motor skills or coordination
  • Vomiting 

Infants suffering from Chiari malformation symptoms may experience: 

  • Breathing problems
  • Developmental delays
  • Difficulty swallowing 
  • Excessive drooling
  • Inability to gain weight 
  • Irritability during feeding 
  • Stiff neck

Diagnosing Chiari malformations

To properly diagnose Chiari malformations, our team will perform a few tests on your child. These tests may include: 

  • Magnetic resonance imagining (MRI): MRIs use powerful radio waves and magnets to create detailed, 3D images of the brain.
  • Computerized tomography (CT or CAT) scans: CT scans use X-rays to obtain cross-sectional images of the brain. 

These tests are necessary to help your child receive the most appropriate treatment, and we want to make sure you fully understand your child’s path forward. We know tests like these can be scary for both you and your little one, which is why we’re here to help you through every step of the process.

At our Chiari malformation multidisciplinary clinic, your child will have access to targeted care including advanced imaging tests, sleep studies and neuro-ophthalmology specialists to rule out intracranial hypertension. This arms our team with the knowledge to best recommend treatment for your child.

How are Chiari malformations treated?

Our dedicated pediatric neurosurgery team uses the latest technology and minimally-invasive methods whenever possible. In many cases, surgery is the only Chiari malformation treatment option. 

Surgery will help ease the symptoms and may stop the progression of any possible central nervous system damage. 

Our pediatric neurosurgery specialists are backed by years of research and experience. With our team approach, your child is in the hands of a compassionate, experienced team who will provide your child with specialized and personalized care unique to their individual needs.

Get complete pediatric neurological care

Our pediatric neurosurgery team and pediatric specialists are here to support your child through diagnosis and treatment.

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