Chiari Malformation Appointment Checklist

The following checklist was designed to help patients organize the radiographic imaging and consultations that may be needed for your evaluation with a Chiari CARE neurosurgeon. (View or download a PDF of the checklist.)

­IMAGING:

___ Brain MRI; dated:

___ Cervical MRI; neutral position – dated:
                               flexion/extension position – dated:

___ Thoracic MRI; dated:

___ Lumbar MRI; dated:

___ Pre-Operative MRI Imaging (if applicable)

___ Post-Operative MRI Imaging (if applicable)

___ X-ray; neutral position – dated:
                  flexion/extension – dated:

CONSULTATIONS:

___ Neuro-ophthalmology evaluation; dated:

___ Sleep Study evaluation; dated:

___ Neurologist

___ Geneticist

___ Cardiologist

___ Pain Management

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