Arnold-Chiari Syndrome (cerebellum prolapse) is the prolapse of the cerebellum towards the spinal cord, passing a certain limit at the base of the skull. It is an anomaly introduced by Chiari, a German pathologist, and although its exact cause is unknown, it is thought to be due to three reasons. These can be listed as 1-) Difference between intracranial pressure and spinal cord pressure, 2-) Impairment of circulation of cerebrospinal fluid due to adhesions in the cerebellum, 3-) Developmental disorders.
4 types of anomalies were defined by the German pathologist Chiari.
Type 1: Prolapse of the tonsils of the cerebellum into the spinal canal.
Type 2: Prolapse of the tonsils of the cerebellum and the main tissues of the cerebellum into the spinal canal. In this anomaly, accompanying malformations are also seen in other parts of the spinal cord (such as meningocele, meningomyelocele).
Type 3: Tonsils of the cerebellum, main tissues of the cerebellum and brain tissues protrude, forming a sac at the nape of the neck.
Type. 4: It is a condition where the cerebellum does not develop from birth.
Except for Arnold Chiari Type 1, these are syndromes observed in newborn babies and accompanied by an anomaly. Type 1 Chiari is an adult disease that most commonly occurs in people in their 30s. It causes complaints of headache, neck and shoulders pain, especially in the neck area. If it progresses, it may cause cape-like numbness in the shoulders, sometimes numbness in the same area, and weakness in the arms and legs. Pain in the neck area and a feeling of pressure in the shoulders and neck are the most common symptoms. If you have these types of symptoms, you should consult a neurosurgeon.
Firstly, a detailed physical examination should be performed by listening to the patient's complaints, and then some tests should be requested. In particular, MRI of the brain and the entire spinal cord should be performed, along with tests such as tomography for bone defects and EMG, SEPP, MEPP for nerve conduction.
The treatment for Arnold Chiari Syndrome is surgery. Since it is a mechanical sagging, there is no medication or rehabilitation method to reverse this sagging. An intensive care bed must be adjusted during treatment.
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