Sunday, 24 October 2010

Day 673 - Chiari Malformations

"In 1891, Austrian pathologist Hans von Chiari described certain hindbrain abnormalities as postmortem findings in infants; these came to be known as Chiari malformations.

Chiari malformations (CMs) are structural defects in the cerebellum, the part of the brain that controls balance. When the indented bony space at the lower rear of the skull is smaller than normal, the cerebellum and brainstem can be pushed downward. The resulting pressure on the cerebellum can block the flow of cerebrospinal fluid (the liquid that surrounds and protects the brain and spinal cord) and can cause a range of symptoms including dizziness, muscle weakness, numbness, vision problems, headache, and problems with balance and coordination.

There are three primary types of CM. The most common is Type I, which may not cause symptoms and is often found by accident during an examination for another condition. Type II (also called Arnold-Chiari malformation) is usually accompanied by a myelomeningocele-a form of spina bifida that occurs when the spinal canal and backbone do not close before birth, causing the spinal cord to protrude through an opening in the back. This can cause partial or complete paralysis below the spinal opening. Type III is the most serious form of CM, and causes severe neurological defects. Other conditions sometimes associated with CM include hydrocephalus, syringomyelia, and spinal curvature.

Medications may ease certain symptoms, such as pain, although many people with Type I are asymptomatic and do not know they have the condition. Many patients with the more severe types of CM and have surgery see a reduction in their symptoms and/or prolonged periods of relative stability, although paralysis is generally permanent. Surgery is the only treatment available to correct functional disturbances or halt the progression of damage to the central nervous system."

I recently had a comment on the Hemicrania Continua post from someone who has been diagnosed with Chiari malformation. Given that I do not yet have a post on this condition, I thought it would be interesting to write a few lines about it, especially as recently various people have mentioned that they are familiarizing themselves with new conditions via my blog. And I have to admit I find it fascinating, albeit at the same time very daunting, to learn how many different conditions have constant headache as one of their symptoms. It goes to show how complex and how intricately connected all parts of the human body are.

And I wonder how many other conditions exist with headache as a primary symptom, which modern medicine has not yet familiarised itself with.

Some of the websites I have read which detail the symptoms of Chiari state that at times an MRI is not sufficient, and that a CT scan can better detect any possible signs of the condition. I myself have had both, so can say I most probably do not have Chiari malformations. Yet again, something to tick off the ‘I most probably do not have this’ box.

As Christmas once again creeps up on us, I am approaching year two of my permanent headache. I feel I have made some progress since it started, albeit only in terms of being able to eliminate what it could not be. As to what is really is, I still do not have a clue. At times I sit back and wonder whether I should not be more worried about this wretched headache and about what it could possibly be, but it has got to a point where I simply push that thought to the back of my mind. I try and forget that I have had this miserable and mysterious headache for so long, this headache which has no doubt altered the course of my life and has put me on a life path that maybe I would not have followed. The only thought I can reassure myself with is that, as I have mentioned before, it has probably made me into a stronger person and enabled me to cope with a condition I previously would have thought I would never have been able to put up with.