There is a treatment for cerebellum prolapse. First of all, cases that require surgery should be selected meticulously. Cerebellar prolapse can be reported on magnetic resonance imaging in many people. However, in reality, very few of them need surgery. In cases that need to be treated, surgery is the only solution. The goal of the surgery is to reduce the pressure of the prolapsed cerebellum on the beginning of the spinal cord. The surgery site is at the meeting point of the cerebellum, brainstem and spinal cord. Microscope and microsurgery are the basic infrastructures of surgery. The surgery begins with the removal of bone structures that will relax the spinal cord and brainstem. Sometimes even just removing bone structures may be enough. In the next phase of the surgery, the cerebellum and spinal cord membranes are opened. Opening the outer membrane, the dura, may be sufficient. However, if it is seen that the cerebrospinal fluid circulation cannot be ensured, the inner membrane of the arachnoid may be opened. In some cases, the sagging part of the cerebellum that is thought to be dysfunctional can be removed. In the last part of the surgery, the dura, which is removed from the body or opened with a synthetic patch, is widely closed with a procedure called duraplasty. The purpose of the surgery is to correct neurological deterioration and cerebrospinal fluid circulation disorder due to brainstem and spinal cord compression that develop as a result of prolapse of the cerebellum. The name of the surgery performed is foramen magnum decompression and “sisterna magna remodeling”.
Chiari malformation surgery
A Chiari malformation, previously called an Arnold-Chiari malformation, is where the lower part of the cerebellum and brain stem pushes down into the spinal canal. Surgical treatment of Chiari malformation is available. Firstly, the cases that need to be operated must be selected carefully. In most people, a Chiari malformation may be reported in magnetic resonance imaging. However, in reality, only a small number of patients need surgery. Surgery is the only solution in cases that need to be treated. The aim of the surgery is to reduce the pressure on the cervical cord due to slumped cerebellum. The area of operation is at the junction of the cerebellum, brain stem and spinal cord. Microscopy and microsurgery are the basic infrastructures of the surgery. Surgery is started with the removal of bone structures that will relax the spinal cord and brain stem. Solid etimes it is enough to take only bone structures. The cerebellum and spinal cord membranes are opened after the operation. The opening of the outer membrane can be sufficient. However, if the cerebrospinal fluid circulation is not followed, it can be opened in the inner membrane called as arachnoid. In some cases, the downward displacement of cerebellum part - tonsillary, which is considered to be dysfunctional, can be removed. At the end of the operation, the dura is closed either with soft tissue taken from the body, or dural patch. The aim of the surgery is to correct the neurological worsening due to the anomaly of the cerebellum and to correct the cerebrospinal fluid dyscontunity. Surgical procedure is foramen magnum decompression and cisterna magna remodeling.
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