Chiari I Malformation
What is Chiari I Malformation?
In this condition, the “cerebellar tonsils” in the back part of the brain extend down into the spinal
canal. This may alter the normal flow of cerebral spinal fluid as it moves from the brain and
down the spinal cord.
Many people with a Chiari I Malformation have a spinal cord cyst (an abnormal collection of
fluid). This cyst is called a “syrinx.” This syrinx may also cause symptoms.
Common symptoms of a Chiari I Malformation
ξ Neck, shoulder or arm pain
ξ Weakness or changes in the feeling in your hands, arms, or legs
ξ Symptoms that become worse with straining or coughing
Treatment of the Chiari I Malformation
Your doctor may suggest surgery to make room for the cerebellar tonsils. Surgery often
improves the symptoms or keeps them from getting worse.
During surgery, space is made for the back part of the brain by taking off the bone lying over the
area and opening up the tissue that covers the brain (dura). A patch is placed to make the space
larger. After surgery, the normal flow of cerebral spinal fluid (CSF) is restored. Often, the spinal
cord cyst will go away in a few weeks or months after surgery.
ξ You will have a physical exam and lab tests that include blood work and urinalysis.
ξ Please schedule this pre-operative appointment with your primary care provider or with a
nurse practitioner in our department.
ξ This appointment should be done within 30 days of surgery—we may cancel surgery
without an updated pre-operative exam.
ξ Please contact your insurance company to obtain any needed referrals.
ξ Please stop the following medicines for two weeks before surgery. It is alright to use
acetaminophen (Tylenol®) if needed.
o Aspirin, Excedrin®, Ascriptin®, and Ecotrin®
o Vitamins and herbal supplements
o Coumadin® or Warfarin
o Ibuprofen, Advil®, Motrin®, Nuprin®, and Aleve®
ξ Wash your hair and neck twice before surgery. Please use an antibacterial soap. Wash
(do not scrub) for 2-3 minutes. Rinse well. Do not use lotions, powders, or perfume.
ξ Please no smoking or exposure to cigarette smoke for two weeks prior to surgery.
Smoking delays wound healing. Cigarette smoke contains a poison that lowers the level
of oxygen in the blood.
ξ After midnight the night before surgery
o You may not eat anything
o You may not drink any milk or juice with pulp
ξ Up until 4 hours before surgery
o It is alright to drink clear liquids
ξ You will be called the afternoon before surgery. At this time you will be told
o What time you need to arrive at the hospital
o The final details about how to get ready for the next day
ξ You will need to sign a consent form that states that you understand what the
neurosurgeon explained to you about the procedure. The consent also states that you
know about the risks and benefits of the surgery.
ξ Do not wear make-up, jewelry, or nail polish to surgery.
ξ This surgery may take about 3 to 5 hours.
ξ A small amount of hair on the back of your head is shaved.
ξ An up and down incision is made from the middle of the neck to the back of your head.
ξ After more room is made for the back of the brain, the tissue cover of the brain (dura) is
ξ A dural patch graft is used which may come from your own tissue or from a man-made
ξ It is best to avoid coughing, lifting, and straining for the next 3 months.
ξ If you should become sick with a severe cough during this time, a doctor may prescribe a
ξ You and your doctor will decide when you should return to work.
When to Call the Doctor
Call if you have any of the following symptoms.
ξ Severe headache
ξ Fever greater than 101.5 F
ξ Redness, swelling or drainage at the incision site
ξ Nausea or vomiting
If you have any questions or need to schedule an appointment, please call pediatric neurosurgery:
After hours, nights, and weekend, call the paging operator (608) 262-0486. Ask for the
neurosurgeon on call. Leave your name and phone number with the area code. The doctor will
call you back.
The Spanish version of this Health Facts for You is #6884
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 2/2015 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5310