First, A Little History

I have Chiari Malformation Type I, and recently underwent a posterior fossa decompression to alleviate and/or reduce the symptoms associated with this condition. I'm now less than a week into recovery, and wanted to put together this blog, or online journal (bjournal?) to keep everyone up-to-date on the surgery and recovery.

Let's Begin at the Beginning

Before delving into my personal relationship with Chiari, I wanted to give an overview of the condition itself. You can look it up on Wikipedia, and here's what it will tell you:

"Chiari-Malformation is a malformation of the brain. It consists of a downward displacement of the cerebellar tonsils and the medulla through the foramen magnum, sometimes causing hydrocephalus as a result of obstruction of CSF outflow."

Wow, thanks Wikipedia! If only i knew Latin. What's really going on here, insofar as my understanding goes, is this:

Nearly everyone who has a brain (I'm looking at you, Joe the Plumber!) also has brain tissue called the cerebellar tonsils attached to the bottom of the brain (the cerebellum). Directly below the tonsils is an open space (the foramen magnum) where the spinal cord meets the brain. For normal people, cerebral spinal fluid (CSF) flows freely between the spinal cord area and the brain area, acting as a cushion between the brain and skull, serving an immunological purpose, and generally making for a happy, headache-free existence.

For the estimated 400,000 people (roughly 1 in 1000) in the United States who are lucky enough to have this condition (lucky as in "Hey, I was just hit in the knee with a horseshoe", not "Hey, I just won $100"), things are decidedly not happy or headache-free. The cerebellar tonsils extend down into the foramen magnum and act like a cork, reducing or stopping the flow of CSF between the spinal column and the brain.

The most common symptoms are intense, stabbing, pounding, gut-wrenching headaches at the back of the skull, and these are often associated with dizziness / vertigo-like symptoms. These ingredients make a nice dish called nausea, which isn't all that tasty and you won't be wanting seconds.

Fortunately for most of you, this condition is congenital (Ron, stop laughing and look it up), and although not everyone who has ACM1 will necessarily have symptoms, for those who do, well... it sucks.


Coming Up Next: Getting the Diagnosis