Amanda’s story
Chiari malformation
Surgery for Chiari malformation helps Amanda feel ‘like they pulled a veil off my brain’
At the end of her journey that ended with surgery for Chiari malformation, Amanda looks back and says that she’s not just healed. Her life, she says, is actually better.
"I sleep better. I have more energy. My gait is normal," she says. "It’s like they pulled a veil off my brain. Apparently, the very first thing I said after surgery was, ‘I don’t have a headache.’"
Chiari malformation is a neurologic condition in which the lower part of the brain, called the cerebellar tonsil, herniates down through the skull and into the spinal canal, blocking the normal flow of cerebrospinal fluid. In Amanda's case, the herniation had grown to 29 millimeters. Her symptoms included trouble swallowing or breathing. She even passed out a few times after coughing.
Today, all of those symptoms are gone, thanks to surgery with Dr. Brad Curt of Mayfield Brain & Spine. Dr. Curt was able to "decompress" the brainstem by removing bone at the back of the skull to create space for the brain, helping to restore the normal flow of cerebrospinal fluid. He created additional space by removing the bony lamina at the C1-C2 levels of Amanda's spine, and thickened ligaments overlying the spinal cord and nerves, called a laminectomy.
MRI scan shows the tonsil herniated out of the skull and into the spinal canal, like a cork in a bottle
Chiari surgery: Bone is removed and a dura patch is sewn to expand the space for CSF to flow around the tonsils.
Dr. Curt says the symptoms of Chiari patients can vary dramatically, starting with headaches and neck pain and ranging to sleep apnea, blackout spells or even cardiac arrhythmia. The critical factor, he says, is how much of the cerebrospinal fluid is being blocked.
"The range of problems caused by Chiari malformation is so wide that many patients, including Amanda, just try to manage the symptoms and power through with their daily life," Dr. Curt says. "Not all patients have the flow obstruction or brainstem compression that would indicate surgery is necessary. Amanda’s imaging made it clear that she needed surgery, and we were able to widen the space for the tonsils and brainstem. She has gotten significant relief from her symptoms, and her outlook looking forward should be strong."
Symptoms from Chiari went back 20 years
Amanda was still living in her native Australia when she first started suffering from headaches about two decades ago. One doctor told her it was probably related to stress. Eventually, she took a scan of her brain and was diagnosed with Chiari malformation as well as hydrocephalus, a buildup of fluid in brain cavities. At that point, the tonsillar herniation was only about 11mm, so she was advised to manage through the symptoms.
"I just pushed through it because I didn't know any different," she says. "I had been told that it was just in my head."
After moving to the Dayton area about 15 years ago, Amanda felt the headaches get worse. When she got bronchitis and started coughing, "I would feel like my head was going to explode," she says.
When she first talked about surgery with Dr. Curt, she was "terrified at the thought of someone opening up my skull." But today, after the operation, she is grateful she listened.
"I feel amazing," she says.
~ Cliff Peale
Hope Story Disclaimer -"Amanda's Story" is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.
Click here to call 513-221-1100