I was diagnosed w/Chiari about six years ago. I’m usually asymptomatic, but have had one “flare up” a few years ago. Now that my first baby is six months old, I’m having some symptoms that I believe are Chiari-related. I started having near-fainting episodes a month ago along with some muscle weakness in my arms and legs and dizziness and head pain.
I had an MRI on July 25th, and this is what it said:
IMPRESSION: There is no acute intracranial abnormality with Chiari One malformation with cerebellar tonsils extending 6.6mm below level of foremen magnum.
There is CSF noted anterior to the brainstorm and medullary cervical junction without neural impingement at the craniocervical junction.
There is increased T2 signal in the sulci of both posterior cerebral hemispheres in the flair sequence of indeterminate clinical significance. Consider obtaining lumbar puncture with analysis of CSF versus CT head to exclude blood products. This can also be seen with proteinaceous material as well. There is no abnormal enhancement in the corresponding sulci with IV contrast administration.
Protocol: Multiplanar magnetic resonance imaging of the brain was performed without gadolinium contrast.
Findings: See above. There is no syrinx identified in the upper cervical cord. Brain parenchyma is unremarkable. There are no abnormal areas of enhancement with IV contrast demonstration. Skull base and calvarium are intact. Orbits, paranasal sinuses, middle ear cavities and mastoid air cells are unremarkable.
So…what does it all mean? The only thing I can find on increased T2 flair is MS, but I didn’t know if anything Chiari-related could also cause this.
I have an appointment with a neurosurgeon on August 24th, but I would like to have some idea of what is going on before then!
Any insight and help is appreciated!
Thank you! I’ve heard very good things about the NS I’m going to see, so hopefully he’ll be able to help me. One of my friends’ daughter sees the same one and she’s having decompression surgery next Monday. It will be good to see how it goes for her…even though I know results vary widely person to person, it’s nice knowing someone else who’s going through the same thing. I have a six month old daughter, so surgery isn’t exactly an attractive thought; but at the same time, if it’s the only thing that will make me feel better I guess I have no other option!
I have been reading about pregnancy and Chiari... Sometimes the straining of pushing can cause issues, and sometimes having an epidural can pull the cerebellar tonsils down further. (Disclaimer: I'm not a doctor, this is just the things I've found as a birth junkie!) It could be that something happened during your birth that triggered symptoms.
I agree with Emmaline - ask about the CINE MRI. Also, there's a phrase I use with my doula/CBE clients: B.R.A.I.N. When your doctor suggests a course of action or medication, ask:
Benefits - What are the benefits of this treatment?
Risks - What are the risks involved?
Alternatives - Are there any alternatives that may be less risky?
Intuition - Take some time to ask yourself how that medication/treatment feels to YOU.
Nothing - What happens if we do nothing? Can we wait a few hours? A week? A month?
Just keep up a dialogue with your provider and bring someone with you for support, or to take notes (since we seem to have memory problems sometimes!).
Good luck!
Katrina W.
Katrina,
Thank you for the info! I don't know if pregnancy itself can trigger symptoms, but I had a c-section since my little one was breech. My water broke the night before our scheduled c-section, and my contractions were 2-3 minutes apart and lasting a full minute the entire hour and a half to the hospital. When we got there (finally!) I was fully dilated, so they got me back to the OR very quickly. Clearly not a "typical" first labor =)
While I was pregnant and a couple of times afterward, I also visited the chiropractor. I wasn't aware then (and especially since I'd been asymptomatic for ~3 years) that doing so was ill-advised for Chiari patients. I don't know if that has something to do with my symptoms resurfacing or not...