Therapeutic tactics depends on the type of malformation and the severity of the symptoms of Arnold Chiari’s syndrome.
Thus, the degree of anomaly is differentiated depending on the displacement of the cerebellar tonsils in the grete occipital foramen, disturbances in the position of the brainstem and the correlation of the structures of the craniocervical junction:
the 1st degree. It appears in adolescence or in adults, and according to statistics the peak of symptoms in adults falls on 40-50 years, which has not yet been explained.
anomaly arnold kiari 2 degrees, 3 degrees. Is manifested in early childhood or adolescence.
Anomaly of the arnold kiari of the 4th degree. It leads to the fact that newborns with such a diagnosis are not viable and die in the first days or weeks after birth.
If the symptoms are mild or moderate, the following may be effective:
- a certain way of life;
- proper nutrition;
- drug therapy.
When the patient has an anomaly of Arnold Chiari, we diagnose in him that the amygdala of the cerebellum is shifted downward into the large occipital foramen. At the same time, the medulla oblongata receives pressure, and this leads to neurological disorders. In the case of severe symptoms or progressive deterioration of the patient’s condition, surgical treatment is required to remove part of the occipital bone and part of the dura mater. This leads to the elimination of compression of the brain structures and the creation of space for the cerebellum and brainstem.
According to literature data and in our experience, the best treatment results are observed when patients are operated on during the first 2 years after the beginning of symptoms. Asymptomatic patients can be observed and operated later if they have symptoms. But it is important to remember that the changes, as a consequence syndrome and hydromia, are growing slowly, and patients often do not pay attention to them until gross manifestations appear. At the same time, already developed violations of the function, as a rule, are irreversible, therefore, the operation should be aimed at preventing their development. As a result of surgical treatment, most of the complaints and symptoms regress in the early postoperative period. A person returns to his functionally full life, provided that irreversible atrophic changes did not develop before the operation.