Compressed CSF pool

[KatMW]

What does the expression:

"compressed CSF pool in the region of the foramen magnum"

Mean please?

The line appeared on my wife's CINE MRI CSF flow study, and I can't find any explanation on the net so far.

Thanks,

Mike

[Abhijeet Deshmukh, MD]

Hello.

The cerebellum needs more space in the posterior fossa. We obviously can not push the brain tissue up inside the skull. The damage will be enormous.

What we can do is remove some parts of the cerebellum which we can do without. Like the cerebellar tonsils. And to add to it, as you rightly mentioned, we remove some bone too, and use some soft tissue patch.

The benefits are much more than the risks involved. Due to this low risk/benefit ratio, this surgery is viable.

Regards

[Abhijeet Deshmukh, MD]

Hello Mike.

The Cine MRI CSF study is done to determine the flow of CSF through the foramen magnum. Normally the CSF flows from the ventricles down to the spinal canal. This is the normal circulation. If there is any block at the level of the foramen magnum (as can be due to Chiari malformation) the CSF can not flow downward. It collects near the foramen as a pool. And the pool is under pressure from the surrounding tissue. (the brain tissue is trying to squeeze out of the foramen, as in Chiari's ).

Regards

[KatMW]

I am hesitant to have even the 'tonsils' of the cerebellum removed, since they are part of the brain.  Does anyone know fully what they do?  What is lost to the patient without them?  Is any retraining of the remaining brain needed to replace what is lost by removing the tonsils?  Our Dr. plans (as of last discussion) to remove just a strip of bone and leave the Dura intact because he believes my wife's 4mm herniation is 'borderline' even though her symptoms are unbearable.

Thanks for the ongoing help,

Mike

[KatMW]

This sounds a lot like a plumbing pressure problem to me, and that is my area of expertise.  If I am following you and thinking correctly the opening of the area of the foramen by removing a strip of the lower skull (Chiari surgery scheduled for 1/22) should relieve the blockage, reduce pressure inside her brain and on her brain stem and greatly reduce her pain and paralysis symptoms.  Does that sound logical to you?

Thanks so much for your simple and clear explanation.

I like this service more every day!

Mike