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Chiari Malformation Specialists

The Metropolitan Neurosurgery Group -  - Neurosurgery

The Metropolitan Neurosurgery Group

Neurosurgery located in Silver Spring, MD

You can have a Chiari malformation and never develop problems, but once symptoms appear, surgery is the primary treatment. The board-certified neurosurgeons at The Metropolitan Neurosurgery Group in Silver Spring, Maryland, have extensive experience in Chiari malformations. They see patients from around the world, they’ve published many articles, and as the director of the greater Washington Metropolitan Chiari Syringomyelia Foundation, Fraser Henderson, Sr., MD, sponsors regular Chiari malformation lectures. If you need expert surgical care for a Chiari malformation, call the office today.

Chiari Malformation Q & A

What is a Chiari Malformation?

Your spinal cord travels through an opening at the base of your skull and then connects with your brain. A Chiari malformation develops when a problem such as a structural defect in your skull or spine allows part of the brain to go through the opening.

When the brain pushes into the opening, it creates pressure that affects the normal flow of cerebrospinal fluid. This can lead to a buildup of fluid in the spinal cord, a condition called syringomyelia, or in the brain, which is called hydrocephalus.

There are four types of Chiari malformations:

  • Type I: The most common type of Chiari malformation, type I occurs during fetal development, causing portions of the cerebellum called the cerebellar tonsils to protrude into the spinal canal. Type I often goes undiagnosed until symptoms appear during adolescence or adulthood.
  • Type II: In a type II Chiari malformation, more of the brain pushes into the spinal canal. This type is usually caused by myelomeningocele, a type of spina bifida, in which the spinal cord doesn’t close properly.
  • Type III: This Chiari malformation is a rare condition in which a portion of the brain pushes out through a defect in the back of the head or neck. A type III malformation is associated with neurological damage and a high mortality rate.
  • Type IV: A type IV Chiari malformation is the rarest and most severe. In this condition, the cerebellum fails to fully develop. Other brain malformations may also occur.


What Symptoms Develop Due to a Chiari Malformation?

When symptoms develop in a patient with a type I Chiari malformation, they experience problems such as:

  • Severe neck and head pain
  • Occipital headache (at the base of the skull)
  • Weakness in hands and arms
  • Dizziness
  • Balance problems
  • Muscle spasticity
  • Blurred vision
  • Sensitivity to bright light
  • Fluid-filled cyst in the spinal cord
  • Loss of sensation in the upper body and arms
  • Delayed motor development
  • Difficulty swallowing


If you have a type II malformation, you may have involuntary eye movements, loss of arm strength, or brief periods when you stop breathing. 

Type III and type IV are rare and serious types of Chiari malformations. Infants with type III may have all the symptoms of type II, as well as developmental delays, seizures, and herniation of the brain through an abnormal opening in the back of the skull. Unfortunately, the underdeveloped brain in those with a type IV Chiari malformation means they seldom survive infancy.

How is a Chiari Malformation Treated?

When you don’t have symptoms, your Chiari malformation may not need treatment. Once treatment is necessary, however, surgery is your only option. Your neurosurgeon may perform procedures such as:

  • Suboccipital craniectomy
  • Occipitocervical fusion
  • Posterior fossa decompression surgery
  • Treatment of syringomyelia, such as inserting a shunt


If you need expert treatment for a Chiari malformation, call The Metropolitan Neurosurgery Group.