Ask your team about low CSF pressure, probably due to a leak in the spinal meninges... Usually very difficult to find. Normal CSF pressure reading doesn't exclude having a leak.... Treatment can be pretty straightforward: an epidural blood patch. But you need to know where the leak is!. My wife was just treated and recovering after having a 14mm Chiari, positive cine MRI and sagging brain. Took over a year, multiple neurologists and neurosurgeons. She had multiple neurological symptoms, some dimensia, memory issues, etc. Severe orthostatic headaches.
Our medical team found a small leak (upper thoractic/lower cervical vert.) 2-4 hrs post injection of contrast material in a CT myelogram. Our radiologist indicated that most of these kinds of leaks don't show up until at least a couple of hrs post contrast material.
There are specific indicators in the structure of a saging brain that point to the likelihood that the cause is CSF leak rather than congenital Chiari malformation, but not everyone knows what to look for.
Hi....with a 4mm herniation most NS do not recognize that as chiari or as possible to cause symptoms.Those that do recognize it will consider it chiari 0.
I am not aware of ne one else with this dx....I hope someone may be familiar or shares this dx and can offer u some info and insight.
Good luck
"selma"