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Neurological Treatments

Chiari Malformation Patient’s Journey

Walking the road to recovery for Chiari malformation can be a complicated journey. If you or a loved one has recently been diagnosed, you probably have several questions. To make the entire process easier, it’s important that you learn as much as you can about the condition. This timeline will walk you through the entire medical process, so that you can make educated medical decisions, understand what to expect, achieve some peace of mind and focus entirely on healing.

About Chiari Malformation

Type 1 Chiari malformation is a condition that came about as your body was growing. In some cases, while the brain grows, the back of the skull does not grow large enough, which causes the cerebellum to block a hole called the foramen magnum. For Chiari malformation type 1 patients, this blockage prevents the flow of cerebrospinal fluid (CSF) through the foramen magnum and puts pressure on the brainstem and spinal cord. A CSF blockage can cause unwanted pain, as well as muscular, sensory and other neurological symptoms.

Quick Facts

  • Approximately 1 in 1,000 people are diagnosed with a type of Chiari malformation each year, but not all are symptomatic.
  • Medications may ease certain symptoms, such as pain, but surgery is the only treatment available to correct functional disturbances.
  • Not everyone uses the same terminology when describing Chiari. Some people use Arnold-Chiari (ACM) interchangeably with Chiari.
  • Chiari malformation affects people of all races and genders, with women slightly outnumbering men in diagnosis numbers.

Treatments

At Neurosurgeons of New Jersey, our team of doctors, nurses and staff focus on creating a patient-centered atmosphere. Individual treatment plans are tailored specifically to you and your unique condition to ensure the best possible outcome.

Treatment for your Chiari malformation will be determined by evaluating several factors, including your symptoms, prior treatments, imaging findings and clinical situation. With this information, we will determine if surgery is necessary and walk you through your treatment options. Ultimately, the treatment decision will be made between you and your doctor, but learning more about your treatment options will help you to make an educated decision about your healthcare.


Our Doctors

Our mission is to provide patients with personalized care by some of the top surgeons in New Jersey to achieve the best possible outcomes. Each of our neurosurgeons has trained to develop the highest degree of specialization in their chosen area. Our dedicated surgical specialists deliver outstanding care and are happy to explain complicated medical concepts in a clear, comprehensible manner to ensure patients and their families are equipped to make wise decisions.

Our goal is compassionate, patient-focused treatment of neurological conditions to help patients achieve the quality of life they deserve.


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Patient Success

From the inception of Neurosurgeons of New Jersey, we’ve continued to focus our efforts on a patient-centric philosophy. Individualized treatments lead to great outcomes for our patients and we customize every treatment plan for your unique condition. We leverage our years of experience, extensive knowledge and the highly specialized tools at our disposal to advocate for our patients and help them along their journey with Chiari malformation.


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Insurance

At Neurosurgeons of New Jersey, we make every effort to provide you with the finest care and the most convenient financial options. We offer several patient resources, in our office and online, that will help you understand your insurance. Paying for medical care can be confusing and managing insurance may seem like a maze, but we’re here to answer your questions.

What to Expect During Your Consultation

Prior to your appointment with a Chiari malformation neurosurgeon, you will need to send over your scans. The receptionist will inform you of what scans are needed when you schedule your consultation.

When you arrive for your appointment, you will be asked to fill out forms. The questions on these forms will help your doctor determine if the symptoms you are experiencing are caused by a Chiari malformation. During your consultation, your neurosurgeon will have a discussion with you about your medical history, perform a physical exam, review your scans and discuss your prior treatments.

Conservative treatments, such as medication, physical therapy and pain management are always recommended first. If you have tried these treatments already, or your neurosurgeon feels that you would be a good candidate for surgery, you will be sent to get a special MRI, which shows the flow of fluid to the affected area.

Regardless if you are recommended for conservative treatment or sent for an additional MRI, you will need to come back for a follow-up appointment to discuss next steps.


What to Expect During Surgery

There are two general approaches to Chiari malformation surgery: traditional and minimally invasive.

A traditional surgical approach consists of a craniotomy, which may be combined with a cervical laminectomy and patch graft. This involves removing a small section of the back of the skull as well as part of your uppermost vertebrae to create more space and sewing a graft to expand the membranous sac that surrounds the brain.

A minimally invasive approach consists of Chiari decompression surgery, which uses specialized instruments and microscopic visualization, allowing for much smaller incisions, faster surgery and less disruption of tissue. The result of both procedures is increased space for the cerebellum as well as the spinal cord, allowing CSF to flow more freely.

Most people who are candidates for traditional surgery are also eligible for this minimally invasive approach, though your surgeon will recommend what he or she feels is best.


Friends and Family Guide

If your family member or friend is undergoing a Chiari Malformation procedure with Neurosurgeons of New Jersey, you should have all the information you need to be a great support system. With this guide, you are equipped with accurate information about where you can wait at the hospital, where to eat and nearby hotels if you are coming from out of town. Your support, friendship and love will undoubtedly further the healing process. We are here to give you everything you need to ensure you can help to make a lasting difference for your loved one.


Recovery & Follow-ups

A hospital stay after Chiari malformation surgery can last from a few days to a week, depending on your individual circumstances. In the days and weeks after surgery, you’ll see your doctors for follow-up visits to monitor your recovery, remove stitches and staples and have any necessary imaging to confirm your progress. You will gradually return to normal activities and patients can usually go back to work six to twelve weeks after surgery.

The healing process takes time, so don’t be discouraged if you don’t immediately experience complete relief. Your recovery is going to be a process that requires adjustments and patience. Adopt a positive outlook and establish a support network that can help you along the way. Remember that your medical team is also here to provide you with advice and support.