Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: arnold chiari disease

Forum: Neurology Forum
Topic: Neuromuscular


my wife recently was involved in an automobile accident. shortly after she started to have several problems such as: frequent headaches, neck pain, pressure in neck, decreased sensations. upon seeing several doctors and neurosurgeons she has been diagnosed with arnold chiari malformation. "ACM". The symptoms i mentioned earlier were not present before the automobile accident. "ACM" has been described to me as being a birth malformity, but i don't understand how, or why, none of the symptoms were present before the accident (she is 27 yrs old.). what effect could/did the accident have on the "ACM"
Dear Craig,

A Chiari malformation is when a portion of the cerebellum (the tonsils) pushes
down the back of the skull into the cervical spinal canal. It is a congenital
lesion that may present with posterior headaches and variable cranial nerve
deficits. There are three degrees of Chiari malformations from I to III, with
Chiari I being the most common by far. Many of these are asymptomatic.

Your wife may have problems for several reasons. First is that the trauma from
the car accident caused the Chiari malformation to briefly pinch the cervical
spine. This may have caused the numbness your wife is experiencing. The other
cause is similar in that the trauma likely stretched the muscles in back of
the head, and they are sore. The worse the Chiari malformation, the more likely
the trauma would exacerbate the problems from the Chiari.

At times Chiari malformations are treated with surgery, though it is unclear
whether or not surgery will be necessary in your wife's case. She may do well
with simple rest and gentle physical therapy for sore neck muscles.

Speak to your neurosurgeon regarding whether he thinks the Chiari is causing
your wife's problems and whether surgery is an option.

Good luck.

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