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Is a 4mm descent no big deal for the cerebellar tonsils?

I was in the hospital with a migraine with nausea and vomiting. While there, they did a CT scan. I was treated for the migraine and after a couple of days I felt better. They sent me home without a word about any test results.
I get these migraines about 4 times per months and they last for days at a time if I can't treat them quickly. Thanks to technology, I was about to view the report online and was kind of surprised to read the report. It says I have approximately a 4mm inferior descent of the cerebellar tonsils below the foramen magnum. Mild Cerebellar Ectopia.
The radiologist recommended a sleep study (no idea why). That piece has since been removed from the report. Odd. If hadn't look at the report, I would never have known anything. It concerns me only because of the migraines but I got the impression that they just don't feel it even warranted telling me about it.

I know enough to know the it doesn't qualify for the Chiara Malformation at a 5mm, but what is the likelihood that this could cause a problem?

Thanks!
2 Responses
Avatar universal
Length is not always indicative of symptoms.   Further investigation is necessary for sure.  Don't wait to get answers life is too precious to waste without answers.  A neurologist with experience with Chiari will definitely be able to help. As well a physiotherapist with experience or using osteopathic techniques will help.  Hopefully Selma will respond soon as well.
1 Comments
Thank you
620923 tn?1452915648
COMMUNITY LEADER
Hi and welcome to the Chiari forum.
You will find much debate about this topic....size of cerrebral herniation....and MILD Chiari...that last one really irks me.....any way....let me try to explain this the way I understand it.

The herniation is not Chiari...Chiari is the malformation of the skull making the area too small for the cerebral tonsils and this causes them to herniate, the symptoms are then caused by the herniated tonsils.....So, can you have a MILDLY herniated skull I think not.

SIZE- Imagine the cerebral tonsils like a pieces of shoestring licorice hanging out of a funnel....long and thin, no matter how long, if thin it is not going to cause an obstruction unless it is tied into knots....now imagine an upside down gumdrop it doesn't really protrude at all, but it can cork up the opening....so the width is more a matter of concern...can the fluid still flow....?

So a CINE MRI which shows in real time if there is any obstruction of CSF flow is something that should be done.....and rule out an obstruction to flow.

Let me tell you my own history on this....my herniations were 4mm and 6mm....you have two tonsils , so there should be two measurements.....I also have a partically retroflexed odontoid which makes the space in there tighter, then to have the tonsils....so, my surgeon suggested surgery to give more room, to allow flow and to help prevent the formation of a syrinx, because I was experiencing CSF flow restrictions, as I was having Drop attacks.

What I am trying to say it, more can be going on and just looking at the size of herniation is not the right thing to do, AND the herniation is not what makes it Chiari.....
You need a true Chiari specialist to help you figure out what is best for you.Just know there are comorbid conditions that come with Chiari and many of them have the same symptoms as Chiari....so, it can be difficult to know what is causing them...and YES, you will have Drs, even Neurodurgeons that will tell you you do not have CHIARI ...I was,, funny how much better I am since I had surgery almost 11 years ago.....

Surgery is not the answer for everyone, but you need the right Dr to help you decide what is right for you.
4 Comments
Thank you. I will definitely be following up. I guess it was wishful thinking.
Can you clarify what you were wishing for? At the least you have a Chiari DX....so, you have been valedated as to why you have been feeling as you have....as to wether or not you are a surgical canidate remains to be seen.....more testing is needed and you need a true Chiari specialist.....Please keep us posted on this journey....and if we can be of any help please let us know....this can be a very frustrating time....hang in there and know you are not alone.
Wishful thinking it wasn't really happening. I have had so many other health problems, just not what I needed. Thanks.
I understand , and I think we have all felt that way....if there is any way I can be of help please let me know.
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