Chiari malformation evaluation and care for children

Learning that your child has a Chiari malformation can bring questions about symptoms, MRI findings and whether treatment is needed. Our team evaluates each child carefully and helps families understand what the diagnosis means, when observation may be appropriate and when surgery may be considered.

Overview

Chiari malformation occurs when part of the cerebellum, the area of the brain that helps control balance and coordination, extends through the opening at the base of the skull. In some children, this can affect the normal flow of cerebrospinal fluid around the brain and spinal cord.

Some children have no symptoms and Chiari malformation is found during imaging for another reason. Others may develop headaches, neck pain, balance problems, weakness or other symptoms that need further evaluation.

Symptoms we may evaluate

  • Headaches, especially with coughing, sneezing or straining
  • Neck or upper back pain
  • Balance, coordination or walking changes
  • Numbness, tingling or weakness in the arms or legs
  • Swallowing, speech or breathing concerns
  • Scoliosis or a spinal cord fluid cavity called a syrinx
  • Symptoms that are changing or becoming more frequent

How we evaluate your child

We begin with a detailed review of your child’s symptoms, development, neurologic exam and prior imaging. MRI is commonly used to evaluate the brain and upper spine and to look for related findings such as a syrinx.

The appearance of a Chiari malformation on an MRI is only one part of the evaluation. We consider the imaging together with your child’s symptoms and exam before recommending treatment or follow-up.

Treatment options

Not every child with Chiari malformation needs surgery. Children without significant symptoms may be monitored over time with follow-up visits and, when appropriate, repeat imaging.

When symptoms are significant, worsening or associated with problems such as a syrinx, surgery may be considered. Chiari decompression is designed to create more space at the base of the skull and improve the flow of cerebrospinal fluid. The exact approach is individualized for each child.

What families can expect

  • A careful review of symptoms and MRI findings
  • A clear explanation of whether observation or treatment is recommended
  • Discussion of the goals, risks and recovery if surgery is considered
  • Ongoing follow-up as your child grows

When to seek an evaluation

  • Your child has been diagnosed with Chiari malformation on an MRI
  • Headaches or neck pain are persistent or worsening
  • There are new changes in balance, strength, sensation or coordination
  • Your child has a syrinx or scoliosis that may be related to Chiari malformation
  • You have questions about whether surgery or continued observation is appropriate

Why families choose Pediatric Neurosurgical Specialists

We are proud to participate in the Chiari Surgical Success Scale (CSSS), a first-of-its-kind national study designed to help neurosurgeons better predict which patients are most likely to benefit from Chiari decompression surgery. As the only participating institution in the Dallas-Fort Worth area and one of only two sites in Texas, we are helping advance research that may improve treatment decision-making and surgical outcome prediction for children and families affected by Chiari malformation.

Call us at (972) 566-6900 to schedule an appointment today.