I’m so confused and trying to wrap my brain around this…I got the report from my cervical, thoracic and cine MRI and it states that my csf flow is “unremarkable.” The NS said its not normal but not the worst he’s ever seen and he’s not ready to wheel me off to susurgery additionally the tonsilar herniation is measured at different lengths in different mris taken 2 weeks apart. (first tons on brain mri 7.5 mm then tons on cervical spine herniation measures 4 mm). I know people can still be symptomatic at these levels of herniation (I have all symptoms of chiari minus headache) but if my csf flow is normal does this mean I am not a candidate for surfery?is it possible that csf flow can also be incorrectly interpreted in mris just like chiaris a-asthey are often said to be incidental. Has anyone had similar reports? Did surfery help? Did you find relief any other way?
Generally speaking, when a Surgeon, doesn't think surgery is the best option, that's worth listening to. That doesn't mean thats the end of the discussion or even that its right, you can always find a surgeon who will do surgery. Surgery in this case for this surgeon simply means he doesn't believe the possible benefit outweighs the risk.
CSF flow varies widley based on a lot of factors from weather (yes I'm serious), time of day, what you have had for food or drink. Unremarkable in "doc terms" doesn't mean normal or abnormal, it simply means at that given time, it isn't such that more study or consideration is necessary.
You made an apt observation when you noted some folks have symptoms when others with a very similar physical exam and studies do not. It isn't necessarily incorrect observation for a chiari to be "incidental" The fact is only about 50% of chiaris are symptomatic of the half that aren't studies indicate only about a fifth get worse. Here is a pretty good study summary pretty consistent with the numbers:
http://www.conquerchiari.org/subs%20only/Volume%206/Issue%206%286%2...
Surgery is pretty rare actually. There are tons of ways to get relief, hopefully the members will step forward with their favorites........... A chiari is a bugger, but there IS a lot have hope for.