Chiari 1

My husband was diagnosed with a Chiari 1 malformation about a month ago. This was after an episode in which he passed out. He was in the hospital for a week while they ran tests. In the last month we have seen specialists and they all agree he does have this condition, but none seem to think it is the cause for these "episodes". in the last month he has lost conciousness a total of 4 times, and all either start with a sharp pain in the back of the head or it is an after effect after waking up, He is 36 years old and no history other that high blood pressure.

my question being if this is not the cause what else could we bee looking at to cause these? All the tests showed no stroke, and it was not believed to be seizure (which he has never had before). Is there something we should be looking at that MRI, MRA, and CT scans would not show. Or is this "blackout" due to Chiari more common than our doctors are aware of. Thanks in advance for any help.

[Dr. A. Srivastava]

Thank you very much for your question; although it is quite hard for me to give you a precise opinion here without being able to examine him, but I would try to provide you some relevant information about his health concern.

In Chiari malformations, the pressure in brain increases which manifests itself as dizziness, diplopia (blurring of vision), migraine like headaches, muscle weakness, facial pain, hearing problems, and extreme fatigue. Sometimes this malformation causes dizziness like you have while working with hands above the shoulder level. Treatment of Chiari malformation depends on the form, severity and associated symptoms. No treatment is required in asymptomatic cases other than regular monitoring. Symptomatic patients may require surgery (posterior fossa decompression surgery). The requirement and pros and cons of surgery in your case should be discussed with your doctor as he knows the severity of problem. Hope this helps.