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MRI results unchanged two years after surgery

Hello,

I was diagnosed with Chiari I Malformation in November of 2010. Because my symptoms were severe, I was recommended for surgery with Dr. Albert Lee in Tallahassee and underwent the procedure in January 2011.

Within the last two months, I've had increased neck pressure and headaches. This concerned me, so I went through my primary to get an MRI done and arranged for the results to also be sent to Dr. Lee's office. Today, I received a call from my primary to inform me that the MRI I had was unchanged from October 2010 - BEFORE I had the surgery. The Chiari Malformation still registers on the MRI.

My question is, how is this possible? I underwent this surgery and never received a follow-up MRI (I was told I didn't need one). Did the surgery not work? Or, did it work, and then the Chiari progressed again? I'm so confused and upset, and I feel like I underwent surgery for no reason at all. My symptoms did seem to go away for a time, but now I'm right back to where I started.

Please help, I'm so confused and I don't know what to do. I think, if I don't like Dr. Lee's answer, I'm going to seek out a second opinion. I don't know what options my insurance will allow (I have CHP), but I'm scared of doing the surgery a second time and have THAT one not work, either. I know Chiari can be progressive, but I just... I don't know, I don't know what happened. Has anyone had this happen before? What could be the underlying cause of something like this?

Thank you so much for your help.
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620923 tn?1452915648
COMMUNITY LEADER

   Yes, the MRI could indicate u still have Chiari as ur skull will not change and some Drs do not touch the herniation and not all retract on their own...this is y some Drs cauterize them to help them shrink into place.. Some Drs remove the tonsils....while others only remove them if they r tangled or twisted in such a manor they will continue to cause an issue post op,

The laminectomy and duraplasty is what makes room for the CSF to flow so the fact u have a herniation is not an issue, what u want to know is, does ur CSF still flow freely.

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Avatar universal
I'm sorry for what you're experiencing, and I hope you can get to the bottom of it.  I agree, it's hard to tell what's going on.  But the Chiari Malformation is the size of the back of the skull, so that is not going to change.  Did they mean herniation has not changed?
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Avatar universal
My doctor is a neurosurgeon, but I do not believe he is a Chiari specialist. His name is Albert Lee and I had the surgery at Tallahassee Memorial Hospital in Tallahassee.

This sounds silly, but I'm not sure the exact terms of what I had done. I know that I had several stitches that went up the back of my head. I believe the laminectomy and duraplasty was part of the surgery.

They did not test for related issues and conditions. The Chiari was found by accident because of a fainting spell I had at work. The fainting was ultimately found to be dysautonomia and low blood pressure.

Would there literally be no changes in the MRI at all? It was a standard MRI, but I would still think there would be some difference before and after surgery...
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620923 tn?1452915648
COMMUNITY LEADER

  Hi and welcome to the Chiari forum.

Well it is hard to say, do u know if u had a laminectomy and duraplasty as part of ur surgery?

There r different types of decompressions Drs can do for Chiari....some do a less invasive without opening the dura to prevent a CSF leak, however, many have to have a re-do as this does not give the room needed and symptoms do return....

Not knowing what u had done makes giving an answer difficult....do u know what ur Dr a chiari specialist?

Did they test u for related issues and conditions? I would think not if u went in so quickly...

To address the herniation...many times they r left untouched as the lamenctomy and dura plasty make more room for CSF to flow sometimes the tonsils retract on their own sometimes not...but Chiari will always show on ur MRI as it is a malformation of ur skull which is not something that is fixed or cured with surgery, surgery is done only to restore CSF flow and slow progression of symptoms.

Again sometimes symptoms can be due to related conditions and not the chiari....u need a chiari specialist to review ur MRI for u and u need more testing to see what is causing ur issues now,
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