Chiari Malformation

Chiari Malformation is a condition in which your child’s brain tissue will extend into the spinal canal. It affects the lower part of the brain (which is called the cerebellum).

Chiari Malformation causes the cerebellum, which is part of the brain that controls muscle movement and coordination, to enter the space that holds the spinal cord. In many children, this isn’t problematic, but for many it can cause headaches and body balance issues. In many kids this is an issue caused at birth. However, few can develop this condition later in life.

There are four different types of Chiari malformation (I, II, III, and IV). Type I is the most common.​

Mostly children will exhibit no signs and symptoms of Chiari Malformation, until the child grows up. This is only diagnosed when the child complains of other issues. Out of the four types of Chiari Malformation, I and II are most common.

Symptoms of Type I Chiari:

  • ​Severe headaches

  • Headaches after coughing or sneezing

  • Problems with vision

  • Problems with speech

  • Pain in the neck

  • Problems with balance

  • Poor hand and eye coordination

  • Dizziness

  • Disorientation

  • Numbness

  • Choking and vomiting

  • Problems in swallowing

Symptoms of Type II Chiari:

In type II, greater amount of cerebellum moves into the spinal cord as compared to type I. The symptoms look like the following:

  • ​Problems in swallowing

  • Changes in breathing patterns

  • Weakness in arm

  • Abnormal eye movement​

​If you witness the above mentioned symptoms in your child, you can consult the doctors at the Children’s Hospital or the Mind and Brain Service Line at The Aga Khan University Hospital for an accurate diagnosis and timely treatment.​
​Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​

After a thorough examination and history, your doctor may ask your child to undergo the following tests:

  • Magnetic Resonance Imaging (MRI) : this will identify if the cerebellum has abnormally gone into the spinal cord region, through a series of 3-D images

  • Computerized Tomography (CT) scan: a CT scan will use X-rays to obtain cross-sectional images of your child’s body.​

Treatment of this disorder mainly depends on the severity of malformation in the brain. If your child shows no symptoms, your doctor may not recommend a treatment of medications for the time being.  
If severity is high, your doctor may refer to the following treatments:

  • Your doctor may conduct a surgical procedure to reduce pressure. The goal will be to stop the progression of changes in the brain and spinal canal, as well as ease or stabilize your child’s symptoms. If successful, the surgery will reduce the pressure on the spinal cord and restore spinal fluids.

  • In the most common surgery for Chiari Malformation, called posterior fossa decompression, your surgeon will remove a small section of bone in the back of your child’s skull, relieving pressure by giving your brain more room.

  • Your doctor also may remove a small portion of your child’s spinal column to relieve pressure on his or her spinal cord and allow more space for the spinal cord.​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

​Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.