Friday, July 31, 2009

Visit with Neurosurgeon

Yesterday was my LONG visit with the neurosurgeon. The first thing I noticed is that they have praise videos playing on the TV. Then, as you are filling out the patient information, they have a sheet at the back for prayer requests because they sit down and pray for their patients on a weekly basis...thought this was neat and very rare in today's society.

Anyway....the dr basically said that I have a mild Chiari Malformation. Here is the description better than what I can say:

******The Chiari malformation is an abnormality in the lower part of the brain called the cerebellum. There are several different forms. The most common type is the Chiari I malformation (CM) which this article addresses. Less commonly, it may be known as Arnold-Chiari malformation, tonsillar herniation or tonsillar ectopia. Most cases of Chiari are congenital, meaning they are present from birth.

In normal anatomy, the cerebellar tonsils are located just above this line called the foramen magnum. But in an individual with Chiari, the tonsils hang below the line (herniate) into the spinal canal. The degree to which the tonsils extend can vary tremendously.
What are the symptoms?

The most common symptom of Chiari malformation is a headache, which begins at the back of the head (neck) and radiates upward. The pain is often made worse or can be brought on by coughing, sneezing or straining. These activities are known as valsalva maneuvers.

Visual problems such as nystagmus (involuntary eye movements), double or blurred vision may occur. Balance difficulties, vertigo and dizziness also may be present. Some people may have cranial nerve compression. This can result in apnea (cessation of breathing), gagging, swallowing difficulties, facial numbness or syncope (temporary loss of consciousness).

Patients may have muscle weakness, particularly in the upper extremities, coordination problems, and gait abnormalities. Imaging of the spine may reveal a fluid collection inside of the spinal cord, known as a syrinx. Some individuals may have hydrocephalus, a buildup of fluid in the ventricles of the brain.
Is there a treatment?

The first step after diagnosis is to consult with a neurosurgeon who has experience treating and managing this disorder. Be aware that you may need to travel and you may wish to consult with more than one specialist.

If symptoms are mild and not progressing, your doctor may recommend conservative management. Supportive care such as headache and pain management, physical therapy or a reduction in activities can help manage symptoms.

An operation may be recommended. This is referred to as a posterior fossa decompression. The surgeon makes more room in the back of the head by removing small pieces of the skull bones. This reduces compression of the brain stem and allows the tonsils to move back into their natural position. The specific surgical techniques will vary among surgeons; no consensus yet exists on the best variation on this surgical procedure.*******

Also, the MRI showed that I have a chronic sinus issue so I need to see a ENT dr. The neurosurgeon wants me to see a neurologist so that I can get the headaches under control. So...I have to see an opthamologist, ENT dr, and a neurologist. I have to follow up with the neurosurgeon in 1 year and repeat a head MRI with neck images.

So, I am going to live! YIPPEE!!!

The girls are good and we are having a blast. More information about them and family life later...maybe during their nap!

3 comments:

Leslie said...

Some how I missed your last post with the results. I'm glad things turned out ok and that you're "going to live."=)

Cathy said...

Ricki -- oh, dear! I, too, have/had Arnold Chiari syndrome from birth which manifested itself as Hydrocephalus around age 17-18, which is why I have a VP shunt now. I had the posterior fossa decompression in 1989 and ultimately a VP shunt placed. I'm so glad that things turned out well with your Dr's visit and I will pray that things are also well with your eye doctor, too! Take Care! P.S --- I love the pics of your kids! They're soooo pretty! Love ya! Cathy (Case Mgmt/Social Work secretary) :-)

Mom of 3! said...

Glad the news is good.... hopefully everything will go well with all the other doctors you have to see.



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