A small recap from a lecture by a pediatric neurosurgeon, Dr. Limbrick. I have to say, I really love when doctors are honest and say "We don't know," and are aware on what needs to be done to improve the understanding of Chiari.
I'm not sure how far these facts extednd to pediatrics only, but in my opinion, it's always good to know
more about the conditions we live with! So here are some facts that I personally didn't know.
* The classic 5mm requirement for "Chiari" diagnosis for US NS is based on 25 patients published in 1986.
* Chiari 1.5 is the usual Chiari combined with brainstem herniation through the foramen magnum;
it can cause more severe symptoms; it is less likely to respond well to Chiari surgery.
* Chiari 0 is syringomyelia without any tonsilar ectopia. First described around 5 years ago;
in a test group of 15 patients, 87% improved after surgery.
* Along with other measurments, a Clivus canal angle can shed some light on how likely is the patient to improve after surgery.
* Syringomyelia is present in 10-20% of asymptomatic Chiari 1 cases
* Up to 75% of symptomatic Chiari 1
* 10-20% of Chiari and/or(I guess) syringomyelia patients will have a sibling or a parent with one of these conditions.
That percentage goes up in twins.
* Along other symptoms, syringomyelia can develop AFTER Chiari surgery! Make regulr check-ups a habit!
* As a rule of thumb, it is thought that a syrinx that is less than 2mm in diameter should not cause a lot of problems.
* Generally, the larger the syrinx, the more problems it should cause.
* Lets swich to CSI now! Chiari Sevirity Index. It was recently developed to help patients
understnad what is more or less likely to improve after surgey. Sets realistic expectations. :)
* Have you ever wondered how do doctors mesure whether you improve? Mostly by their own opinions
that have formed in minutes of talking to you. Only 5% measurments are made by a 'Patient-response instrument'.
* A study of around 2000 cases(from 3 US states) of Chiari surgery showed 18.7% surgical complications and 5% medical complications over 90 day period after the surgery.
If you want to learn some details, go ahead and watch the lecture here! It is very informative. The lecture is around 40 min long, there is around 20 min long intro and the rest is Q&A.
These lectures always lift my spirits, because I see people being honest, truthful and invested in the future of chiarians. :)