I have had extremely bad headaches all my , and. I was diagnosed with chiari malformation in 2012. My cm is 5-6mm. My neurologist (Dr. Arora) seems to think that the chiari malformation is not the cause of my headaches, but headaches aren’t my only symptom. I also have extreme weakness, dizziness, and extreme trouble sleeping. I have had my thyroid, my heart, my adrenaline glands, and my testosterone levels checked. I have also had a lot of blood work done. All the results for the things I mentioned are normal. But the Dr still doesn’t think that it is chiari malformation that is causing my problems. I have an appointment with a neurosurgeon (Dr. Joel D. Pickett) on August 12. Is Dr. Pickett good with chiari malformation? And also I have been out of work on short term disability for about 4 months now. So I am trying to speed up the process. I have had an MRI done on my brain with and without contrasts, but I was wondering if there are any other MRIs that I can get my GP to order for me so that Dr Pickett will already have the results for them by the time I see him. If anyone can help me or give me advice then please respond.
It’s very frustrating and there is really no “fix” mine is at 8 mm and I had many of your symptoms plus many more! I had skull decompression in 2010 it helps with weakness and some dizziness but often changes headaches to different type from chari pressure headache to dull chronic headache. I take topimate or topimax for life (it seems) to try to control and migrain meds) I use over the counter excedrian migrain works really well for the head pain too! I’m sorry but it’s a life time of learning to live with it! You need plea by of rest and eat food foods! I just had my neck injected for relief last week. Surgery is painful and recovery is rough at best!!! Try everything you can first is what I recommend after going down this road a long time! My surgery was 5 years and today I still fight head aches, visions issues, tiredness, body aches, muscle weakness ect… I refuse to let it take my life I fight to keep going! I scuba dive, snow ski, and chase grand kids on the good days 
hang in there and fight! Just know surgery doesn’t mean cured!
CINE MRI. Measures to see if your cerebrospinal fluid is blocked or leaking. Neurosurgeon will want to have that done so get it done beforehand, otherwise you will have to wait longer. And those neurosurgeons take awhile to get in to see anyways.
Had Chiari decompression almost 2 yrs. ago. Mine was only 6 mm as well, but Cine' MRI showed no CSF flow posteriorly. After 11 years of constant headaches (base of skull), dizziness, vertigo and numerous other symptoms and misdiagnoses, I decided to have the surgery. I saw 3 different NS who all basically said - the choice is yours and to ask myself these two questions:
1. Have I exhausted every other option for the symptoms (yes - more specialists, tests and meds than I can count).
2. Has this has drastically changed my life (yes- totally, I had to quit my job as a Physical Therapist Assistant 4 years ago).
Well - if I had to do it all over again, I wouldn't choose the surgery. It was a really tough recovery and I had complications and suffered nerve damage to the main branch of my occipital nerve. I do not have a skull-based headache every day, but still have headaches, dizziness, vertigo and nearly every other symptom before the surgery, plus constant pain from the nerve damage. I have been getting 20 nerve block injections every 3 months with little relief.
I was desperate for relief and thought surgery had to be the answer. It was not. The percentage of success is not that high. The only way I would ever do it if I had that choice again was if I had a Syrinx and could end up paralyzed or it was threatening my life in some other way.
Like someone else mention - surgery is not a cure!
CINE MRI is NOT used by most reputable surgeons. It is the result of an academic study done some time ago. It never left the academic arena as a real tool. Headaches centers and a few of the less reputable surgeons jumped all over it however as "proof" of the need of surgery. There is not many places you can actually get one. Fortunatlly for all most of those guys are out of business especially based on the longer term outcome numbers. As read these boards you will find that the glowing success stories are being replaced by those of multiple surgery or return several years later of the same if not worse symptoms.
That is NOT to say there is not a time and place for the surgery. Only 10% - 15% of Chiari patients are receiving surgery. Of those maybe half get relief.