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Treatment for cerebellar tonsilar herniation below the foramen magnum line causing crowding of foramen magnum?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Please find below the “CERVICAL SPINE diagnosis” of my 3.5 yrs old son. Please advise me what best to be done for this.

Cerebellar tonsilar herniation 8 mm below the foramen magnum line causing crowding of foramen magnum – XXXXXXX chiari malformation type I

Multifocal syringomyelia involving cord from C3-C4 to upper border of C7 vertebrae level, D6 vertebra level and D9-D10 to D10-D11 vertebrae level.
Thank you very much for you help in advance!!!
Posted Mon, 1 Apr 2013 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 15 minutes later
Hi,

Thank you for posting your query.

I have gone through the reports sent by you. CT scan of brain is normal.

MRI of the cervical spine shows that part of brain (cerebellar tonsil) is descending down behind the cervical spinal cord, and compressing on it. Also, there is water accumulation & cavity formation in the spinal cord in the cervical region (syringomyelia).

Neck pain is due to the above problem. If not treated, it can lead to pain in the arms, weakness of arms & legs, and imbalance of limbs.

The definitive treatment is surgery- foramen magnum decompression- done in the upper neck and lower back of head region.

You can consult a neurosurgeon for the surgery.

Hope it clarifies. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
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Follow-up: Treatment for cerebellar tonsilar herniation below the foramen magnum line causing crowding of foramen magnum? 1 hour later
Hi Doctor, Thanks for the advice.

If Surgery is must, can we wait for another 1.5 months?

Can this surgery resolve the water accumulation & cavity formation in the spinal cord in the cervical region (syringomyelia)?

Can this surgery leads to any other complications in future or re-occurs in future? And what is the success rate of this surgery.

I came to know through web that, as part of the decompression surgery, part of the scull bone is removed to create more space to the brain. Since he is 3.5 years old, when he grows up, if there any unequal growth of brain and scull will cause any issues.

Sorry for asking too many queries. Hope you understand my situation.

Since I’m living in Chennai, Please recommend one or two best surgeons in Apollo hospital(Chennai).

Again Thank you very much for your help and support.

Regards,
XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 5 minutes later
Hi XXXXXXX

Thank you for getting back.

My answers to your queries are below:

1. Yes, you can wait for 1.5 months.

2. This surgery would help in improving syringomyelia too, as the cause for that also is cerebellar tonsil herniation and pressure on the cervical spinal cord.

3. Success rate is more than 95% in best centers, and the chance of recurrence is less than 2% after a good surgery.

4. The surgery would not lead to any adverse impact on the growth of brain and skull.

5. Regarding Neurosurgeon in Chennai, I do not know anyone personally. However, I worked at CMC Vellore for 15 years. There Prof V Rajshekhar and Prof Ari XXXXXXX Chacko are excellent.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
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