Diagnosing and Treating Chiari Malformation

Chiari malformations can be difficult to diagnose, since the symptoms can be vague, or there may be no symptoms at all. A definitive diagnosis is generally made after an MRI scan, where the abnormal protrusion of the cerebellum toward the spinal cord can be seen. In some cases, the diagnosis may be incidental, meaning that a patient who undergoes an MRI scan for another reason may be diagnosed with Chiari when the scan reveals the abnormality – in these cases the patient may not have experienced any symptoms at all (see Pictures of Chiari).

Anyone who receives a tentative diagnosis of Chiari should always be referred to a neurosurgeon, who will conduct an evaluation and recommend a course of treatment.

In addition to an MRI scan of the brain, an MRI of the entire spinal column is useful. In some patients with Chiari, a cyst (known as a syrinx or syringomyelia), forms within the spinal column. Symptoms of leg numbness or scoliosis are more likely when a syrinx exists. There are also special MRI studies that can measure the direction and degree of fluid motion around the Chiari malformation. This MRI can help in the decision-making process regarding treatment.

Treatment may not be necessary at all when no symptoms are present. When an asymptomatic patient is diagnosed with Type I Chiari, regular monitoring by a neurosurgeon may be all that's needed. (See Doctors Who Treat Chiari.)

Type I Chiari, once diagnosed, is rarely progressive. However, since a small number of patients may show progressive symptoms or MRI changes, ongoing monitoring is recommended. Treatment for Type I Chiari relies on a surgical procedure aimed at making more room at the site of compression. The results of treatment for CM-I are excellent, with the majority of patients experiencing partial or complete resolution (80 to 90%) with few or no complications. (See Surgery for Chiari.)

Type I Chiari can be corrected with surgery to relieve the pressure on the spinal column. Surgery usually produces excellent results with few or no complications. In patients with hydrocephalus, a minimally invasive procedure called endoscopic third ventriculostomy (ETV) can drain the fluid.

Find out more about Chiari CARE at Weill Cornell

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What our Patients Say

Slaton Spinks was small when he was born, but he seemed healthy. As the Texas baby grew, however, his parents, Brandee and Kevin, started to note some peculiarities. “He was delayed, and he just did things differently,” Brandee recalls. “He’d do the...
Cole Sparks was never one to complain. The active 12-year-old Long Island boy lived and breathed lacrosse, and his hard work had earned him a place on the local youth travel team. His proud parents, Chris and Marisa, describe him as “stoic,...
Joe and Christine Pecoraro write about their son Caleb, who underwent surgery with Dr. Greenfield for basilar invagination and Chiari malformation.
Ashleigh and Patrick Kennedy spent four years trying to find out why their little girl was so sick. She was already being treated for a blood disorder, but doctors said her headaches were not related to that. Her eventual diagnosis and treatment for...
Danielle Dietz had a lot of headaches as a high school student, but it wasn't until she learned to trust herself that she found the solution she needed
Sarah and Doug DeMarrais never expected to become champions for Chiari — a condition they'd never even heard of until their daughter was diagnosed. Here is their story.
Kelly, a swimming champ and Olympic hopeful, resisted Chiari surgery until the pain became unbearable. This is her story. I am one of three girls in my family — all competitive swimmers. My parents wanted us to learn to swim after my uncle drowned....
Patti Ventura was shocked by her son's diagnosis, but she transformed her initial shock into determination to secure the best outcome for him. Since that time she's also raised thousands of dollars to help support Chiari research. Here is her story....
Connor was a 15-year-old high school student when he was diagnosed with a severe Chiari Malformation. Here is his story.

Our Care Team

  • Chairman and Neurosurgeon-in-Chief
  • Margaret and Robert J. Hariri, MD ’87, PhD ’87 Professor of Neurological Surgery
  • Vice Provost of Business Affairs and Integration
Phone: 212-746-4684
  • Vice Chairman for Academic Affairs
  • Associate Professor of Neurological Surgery, Pediatric Neurosurgery
  • Associate Residency Director
Phone: 212-746-2363
  • Victor and Tara Menezes Clinical Scholar in Neuroscience
  • Assistant Professor of Neurological Surgery in Pediatrics
Phone: 212-746-2363
  • Vice Chairman, Neurological Surgery
  • Director, Pediatric Neurological Surgery
Phone: 212-746-2363

Reviewed by Jeffrey Greenfield, Ph.D., M.D.
Last reviewed/last updated: April 2021

Weill Cornell Medicine Brain & Spine Center 525 East 68 Street, Box 99 New York, NY 10065 Phone: 866-426-7787