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539750 tn?1226521677

My MRI Report

Cranial MRI

The cerebellar tonsils protrude through the foramen magnum approximately 9.4 MM.  The tonsils are moderately deformed, typical of the Chiari Malformation I.  Crowding of the structures at the foramen magnum is noted.   There is effacement of the cisterna magna and the permidullary cisterns.  There is a cyst-like pineal gland measuring 11.5 MM maximum diameter, unchanged as compared to prior exam.  There is possibly slight capsular enhancement surrounding the pineal gland, however, the enhancement could represent simply displaced vessels of the galenic system.  

Other than slight deformity of the posterior third ventricle, the ventricle system is normal.  The subarachnoid spares are otherwise unremarkable.  No abnormal white matter is identified.  The arteries of the circle of Willis appear intact.  The deep veins and durovenous sinuses demonstrate normal flow effect.  There is no evidence of cytotoxic edema, hemorrhage or subdural fluid accumulation.  The facial structures appear unremarkable, and skull base structures appear normal.


Cervical Spine MRI

Again noted is the tonsillar ectopia described in the cranial MR report.  There is no evidence of blocked vertebral body.  The bone marrow signal is normal.  There is no fracture or deformity.  The osseous craniocervical relationship appears normal.  No evidence of occipitilization of the atlas is detected.    The vertebral bodies are intact.  The vertebral alignment is normal.  The intervetebral disk appears grossly normal with slight C5-6 and T1-2 disk bulging.   There is no stenosis, either of the spinal canal or the intervetebral nueral foramina.   The spinal cord appears normal to contour, signal and position.  There is no evidence for stenosis either of the spinal canal of the intervertebral nueral formina.
19 Responses
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679866 tn?1240005366
Well seems we are on the same pathway. Our symptoms were similar and now you have had your surgery  it was interesting to go back over this thread. I hope I turn out to be happy with results like you.
x Sue
Helpful - 0
620923 tn?1452915648
COMMUNITY LEADER
Hi...ur NS may not be a chiari specilaist.Old school methods of determining if someone had chiari was by the size of the herniation.It has been recently found that u can have no herniation but severe chiari symptoms.CSF blockage is moe important than the size of herniation.

I can only assume which I prefer not to, but I assume ur herniation is 5 or 6 mm or less.

Were u also checked for a syrinx...tethered cord?Depending on what else is going on will depend on which issue is tackled first.

Godspeed
"selma"
Helpful - 0
Avatar universal
My MRI report said: low lying cerrebelar tonsils, do not meet descent criteria...which was a shock to me, my tonsils did not meet descent criteria?  I went to see a ns because of the knowledge i gained from this forum and just the fact that others have the same symptoms.  He said that I did not meet the criteria but there was crowding in the Posterior Fossa. This is apparent enough to warrant surgery.

Helpful - 0
539750 tn?1226521677
Eddie, I am in the same boat.  I was told I am a candidate for the sirgery, w/ no syrinx.  The NS said I can have it now, or wait.  He said there is no guarantee the symptoms will get better and that doing the surgery is to get your CSF flow back to normal, not to help the symptoms.  

I don't want things to get worse, or become permanent, but the NS also said I have to consider that I am an otherwise healthy 26 year old and the surgery, like all surgeries, can have complications. Stroke, nerve damage, nuerological damage, or death.  Of course he said those risks are very small...

I asked the NS how many surgeries he has done on Chiari pateints and he will not give me a staright answer.  He did say he has done several decompression surgeries, I am not sure if this is the same as actually treating someone with Chiari.

I am getting a 2nd opinion in a few weeks and this weekend I will be with some of my families friends and one of the guys has Chiari and had the surgery.  So I will talking with him about it.

He already told me to have it done and the sooner the better.  But I am still unsure if it's the right time.

I am worried about my symptoms though.  My vision and short term memory are a concern.  I am also gettign weakness in my arm...if I hold utensils my hands start to shake.  I want to be an artists (my avatar I drew) so I am concerned about this.

I also figure skate and want to make sure I can remain active.

Also, the doctor I see on 12-3 specializes in pediatrics, but will see adults...
Helpful - 0
620923 tn?1452915648
COMMUNITY LEADER
well it is brain surgery, and can cause other symptoms u didn't have b4 going in.....talk with some of those that just had surgery...Shane99....Lovemygirls2...and Lovage.....

U have to be careful...yes u need a NS, but not all r chiari specialists....all NS can do chiari surgery, but u really need the expert.

if u r willing to go to NYC...go check out the chairi institute......google the name...they have a very informative web site.
by the way I did see the US military had 2 drs listed on the WACMA site.....not sure if they r experts or if they may be someone u saw already....

Keep us posted.

Godspeed
"selma"
Helpful - 0
Avatar universal
I meant Cornell.  I just beleive that my symptoms are evident and that the malformation can only get worse. Why not have the surgery now and get it over with?  While you may have to live with the same symptoms if the surgery is not a success but, I expect, there would not be any new symptoms presenting themselves.

I currently am not seeing that Dr that was just someone who was referred to me.  I will have to wait for  the outcome and use military doctors.  Hopefully they have some experience.
Helpful - 0
Avatar universal
She had it three years ago.  She said that she had to see a nuerosurgeon because the neuoroligist are more difficult to deal with.  The doctor is from NY he is a specialist in pediatric chiari and I beleive he works out of columbia.

What kinds of tests would the chiari institute run on a person aside from the MRIs?
Helpful - 0
620923 tn?1452915648
COMMUNITY LEADER
...well that is ur choice, and as long as u r happy and confident in ur dr then u have to do what u feel best.
I have not heard of Dr Souweidane's name mentioned b4.....but I am sure u did ur research and made sure he was a specialist....how long since ur friend had surgery?
it is good to hear such positive outcomes to the surgery.

I hope u continue to post here ur updates and join in our social threads.

Godspeed
"selma"
Helpful - 0
Avatar universal
I am in  the military and currently in Maryland.  I spoke with a woman who had the surgery, she has never felt better.  She said  that her doctor was Mark Souweidane, and that he was very good.  You can find him if you google him.  I am pretty convinced that I want to have the surgery and do not want to be told to wait at all.
Helpful - 0
620923 tn?1452915648
COMMUNITY LEADER
u will find many here that feel the same.....and u r right, ur can get perm damage that can not be helped if u have a herniation that causes parallasis. And it is congenital, and can have several family members with the same condition.

most important is to find a chiari specialist....where do u live?

join us in our social activities here on the forum!

keep us posted on ur upcoming MRI.

Good luck
Godspeed
"selma"
Helpful - 0
Avatar universal
I am getting my MRI dec 10th, 6 years ago a cat scan said that Chiari 1 was a probability.  I was told it was not a bog deal.  I decided to have it followed up when my mother was diagnosed with it.  My brothers may also have it.  I read somehere that the longer you live with the symptoms the less affect surgery will have in easing it.   I have experienced eye headaches in the past, whenever I cough my head hurts,  when I sneeze my shoulders down through my arms go numb and I feel a stinging pain, also I see spots sometimes when I sneeze, clear spots that go away after a few seconds.  Also, whenever I am out at a concert bar or sports game, and I am yelling/laughing a lot I have to stop because I get this furious pain in the back of my neck, causing me to tuck my head forward almost to get away from the pain.I am pretty sure I have sleep apnea and am waiting to get that diagnosed.  I also have anxiety/depression, My hands have gotten weak and I have a constant nagging minor pain on the back of my hands.  
Helpful - 0
Avatar universal
I hope you get everything straight out.
Helpful - 0
539750 tn?1226521677
Hi Sue,

Make sure to post an update once you get your MRI report!   I do think a lot of people have the same symptoms, which is odd that they get pushed aside.  I know for my visit with the NS the doctor couldn't agree or disagree that the symptoms I have are related...

Then he tells me to research symptoms and I did, but he still doesn't think they are related, but again he just won't commit.  I think it's because of it did the surgery and said yes, X, Y, and Z are related and those things didn't get better after surgery then he must think I would consider it a failure and him a failure.

I am anxious about it.  But I am having a 2nd opinion in two weeks so we will see what he says.  If you go to TCI they have a symptom sheet to fill out before your visit.  So why, if they, being speicalist consider these things to be symptoms don't all NS's?

That is what I don't get.

Good luck with your visit, you have a long road ahead of you, but you will have pleanty of company!

Kim
Helpful - 0
679866 tn?1240005366
Hey there. This has been a very interesting read for me - forgive me for butting in here.
I am going to have my first MRI next Wednesday after having a Chiari 1 diagnosed by CT Scan. I guess so as i have the same info you have above here.
I can see your delimma and am thinking it is quite possible I may have the same - my symptoms are very like yours - though I guess so is most of those people here.
I am thinking I would probably go for the surgery only cause I would live in a constant state of anxiety over what "could" be happening in there and the cost of frequent MRI's must take its toll also. This is only what I personally would be thinking as this is the way my thinking operates. I guess each person has to do what is most comfortable to them.
I dont like op's and the risks either......................some would say we are lucky to have a choice..................Good luck with whatever you decide. Thoughts are with you.
x Sue
Helpful - 0
539750 tn?1226521677
I have headaches (Chiair ones), migraines, short term memory loss, vision problems (blurred and nystagmus, difficulty swallowing, nausea, dizziness, loss of concentration, tendonitis in my right arm (not sure if related), muscle weakness in my left arm (this is new, I get the shakes when I try to do something in both arms now), slight neck and back pain, frequent urination.  Most of these are new, with in the last two years.  I can function, but sometimes I just need to sit at home or sleep because of the headpain or neausea.  I am not on any pain meds, which is what I prefer.

The headaches are difficult and the neausea, but I am still able to work.  I am more worried about 1. waiting too long that something becomes permamanent 2. that something else happens and I am not in as good of health as I am now to have the surgery.

I really don't want to wait until I can't work, by then I feel it is too late.  Right now I have SDD through work which covers my remaining paycheck not covered by SDI.  If I got fired because I wasn't able to work or wasn't doing a good job then I would have that benefit...

Yet the surgey does have it risks, maybe less with someone my age (26), I don't know!

I did suggest hvaing MRI's every few months to monitor for  a syrinx...

As for the cyst, I have an MRI scheduled for a year from now.
Helpful - 0
555358 tn?1292532061
What symptoms are you having? I know you've told us before, but I don't know where that thread may be.

The reason I'm asking is; if they aren't too bad you might consider waiting and just keeping an eye on things. I know I'm usually a big proponent of surgery, but unless the symptoms are effecting your life on a big scale - like not being able to hold a job - you don't seem to be in any danger yet of serious problems, like paralysis.

You do have a fairly large herniation and you should keep a close eye on it, but by itself, it may not be worth taking the risk of surgery.

Disclaimer - The above is all my opinion and I am not a health care professional :D

Check with your doctor (is he a neurologist or neurosurgeon?) and see if he will order follow up MRI's fairly regularly. Perhaps every few months. This way you can make sure no syrinx develop and keep an eye on the cysts to make sure they aren't getting any larger.
Helpful - 0
620923 tn?1452915648
COMMUNITY LEADER
B4 u drive urself crazy trying to sort it all out, talk with those that have had surgery....Shane99...Lovage  .....and Lovemygirls2......I know there r others...they r the most recent.
I am sure one of them will reply...or do another post with a direct question.

Is ur NS a specialist in Chiari?....maybe u r not comfortable with him.....if so, find one u r comfortable with...it is a big decesion and u need to have faith in ur surgeon.

Keep us posted....and join in our social activities here!!!
Godspeed
"selma"
Helpful - 0
539750 tn?1226521677
Hi Selma,

First, congrats!

I saw Dr. Abdou again with my husband so he could get an understanding of all of this.  I am stil just as confused.  I was told because of the size of the Chiari I am a candidate for surgery because there is some blockage.  But since I don't have a syrinx I don't need to have the surgery.  But a syrink could always form later thus requiring surgery.  

The doctor could not commit to any of the symptoms being related and thus said if I had the surgery it would not be to releive or cease symptoms...

I did tell him that all of these symptoms are new, with in the last year or two and I asked him if he monitored any of his other Chiari patients after surgery documenting what symptoms got better and which ones didn't.  At first he said he couldn't share that with me because of patient confidentiality and then he said that he didn't monitor his patients after surgery...

He said I could look online and do research to see what symptoms were listed and possibly related which I did and even gave his news a copy of this highlighting mine.  But he still says he can't say if they are related of not...

So I can have the surgery if I want, but I am generally healthy and the surgery does have it's risks.  

With regards to the cysts, he said it could be a tumor and at that point could be life threating (or if it's a cyst and get's bigger).  He said they could do a lumbar punture to test the fluid to see if it's a tumor, but that could make my Chiari worse...so that is out of the question.

Aaaahhhh, I am so confused! I feel like I should just flip a coin!
Helpful - 0
620923 tn?1452915648
COMMUNITY LEADER
Hi Kim,

Well finally u had u tests and now ur results....I am not a medical pro...so most of this is confusing to me too.....but is is clear u have chiari wiwth a big herniation....u also have a pineal cyst.....who was it u went to?...did they discuss this with u?......I am wondering what u were given as options.

I do not have a pineal cyst....but do have the stinosis...which u don't....

keep us posted
Godspeed
"selma"
Helpful - 0
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