I was wondering if any of you have a pseudotumor along with your Chiari. If you do, what medical treatment was done for it? Did the treatment help your symptoms?
I have what my NS suspects is a pseudotumor along with my chiari. I had a CINE with showed restriction (but no blockage) in 4 places. Because studies show that decompression surgeries often fail if there is a pseudotumor, he is continuing tests before he will even consider a chiari decompression surgery.
This week, I will have a C Reactive Protein blood test to look for general body inflammation (that could be causing the inflammation in my brain), and a blood test for gluten allergies. If those are "normal", then a spinal tap will be next. If that is "normal," then we may talk surgery for the Chiari.
He said that pseudotumors can cause Chiari, but a Chiari Malformation canNOT cause brain inflammation.
I would love any thoughts you have on anything I wrote and on your own experiences.
Your neurousurgeon is doing the same thing I would. Chiaris are from 1 of 3 things. Usually, the posterior fossa is too small and a Chiari decompression is indicated. The second is a tethered cord, pulling the Chiari down(in which case cord untethering may improve the Chiari). The third is elevated intracranial pressure pushing the brain down(cyst, tumor, pseudotumor, hydrocephalus, etc). If you undergo a Chiari decompression and pseudotumor is the underlying cause, the risk of pseudomeningocele(CSF leak) is much higher, as is failure of surgery to improve symptoms. Clearly, when I talk about surgical indications, I'm talking anatomically. The ultimate surgical decision in the case of Chiaris is basd on symptoms.
thanks for your responses! I am so glad that my NS is turning over every rock before we consider brain surgery.
What I hope is that if the pseodotumor is the main problem is that there is a treatment that will help my symptoms. We should have all the answers to the pseudo issue in the next couple of weeks as I am starting with the blood draws today, then it will be off to a spinal tap if the blood results are normal.
Dr. Trumble, I have a question:
If a pseudotumor is brought under control, do you know if the cerebellar tonsils go back up? Also, I was wondering your thoughts on this....my right tonsil is at 6.5 and my left is at 0mm. Have you ever heard of this?
thanks so much! I appreciate the input
There is medical management for pseudotumor(Diamox), surgical management(usually a ventriculo-peritoneal shunt), and environtmental(weight loss). In most cases, if the pseudotumor gets under control, the Chiari stabilizes to improves(as do the symptoms).
Yes, there is often some asymmetry of cerebellar tonsillar descent. No one really knows the significance and we usually pay attention to whichever number is highest(the greatest degree of ectopia).
I am kin the testing phase before seeing dr oro in Colorado and they dd blood work and say c-reactive proteins are high 10. Im being told nothing more until i see dr oro on the 24th…its so concerning to me…no more tests will be done between now and the 24th…and i live 5 hours away.so im staying Thank god,with a brother.its very difficult because he does not speak much english…ive been here since march 29th.I sooo wanna go home…But dont look forward to the drive.I was in really bad shape when i arrived here.that drive is so very Painful…im hoping i get answers soon…I understand the Phys assist.doesnt do the Doctors job.its just so difficult this
waiting…im glad to see your post. Not that I would diag myself,yet i am just trying to get a lead as to why the high c reactive…