Dr. Bolognese's Answers

[Guest guest]

Hi Everyone,

Dr. Bolognese answered some of our questions. For those that don't know Dr.

Bolognese, he is at The Chiari Institute at Great Neck in NY. Here is a link

to their web site. http://www.chiariinstitute.com/ You will see many of us

refer to him as Dr. B. If you talk to most of us that have seen him, we

probably don't pronounce his name right. Kathleen

1. Is flying in pressurized or non pressurized planes safe before or after

surgery.

There is no absolute contraindication for either kind of flight.

Pressurized planes are more comfortable, before and after surgery.

Non pressurized planes are also more " jumpy " since they fly at lower

altitudes.

2. How does CM impact short term memory?

Problems with effective retention of short term memory are part of the

" brain fog " phenomenon.

As recently shown, it is a reversible deficit, not a form of dementia.

4. Does Chiari cause degenerative disc disease, especially in the cervical

area?

Chiari patients do not have a higher incidence of disc disease.

Chiari patients with EDS (and other connective tissue disorders) DO have a

higher incidence of disc disease.

5. Over the past year we have heard from several members that have seen

surgeons, even some of the expert surgeons that have told them that small

syrinxes can not cause symptoms, even pain. Has there been any recent

research on this subject. What is your opinion?

First, define " small "

Most of the slit-like SM's are asymptomatic or oligosymptomatic.

Many enormous SM's are often asymptomatic for long periods of time.

Whenever symptoms and/or neurological signs are present and a SM is

identified, the specialist has to rule out first whether signs/symptoms and

the SM are connected (mostly by anatomical correlation and distribusion).

If the anatomical correlation does not match, the SM is considered

asymptomatic.

Exacerbation of the same signs/symptoms during Valsalva maneuvers are a

strong indication for a symptomatic SM.

6. Likely due to the limited amount of Chiari research, it often seems that

Chiarians are facing the same challenges today as they did 10 years ago. Too

often we hear a doctor say " You have CM, but that's not causing your

headaches. You have migraines " You're just depressed:. " Chiari doesn't

cause symptoms " . " It's not Chiari if the herniation isn't at least x (insert

almost any number here) mm " , etc.

Where do you see us 10 years from now, in terms of physicians' understand of

Chiari?

The landscape has improved, mostly on the Neurosurgical sites.

The Neuological world is still behind.

7. What symptoms would be present if a muscle dura patch were to become

dislodged or leak?

Suboccipital headaches, bulging of the surgical wound, and in some cases

leakage of fluid through the recent surgical incision.

Additional symptoms can include dizziness, postural headaches, double

vision, unstable gait, fatigue. etc.

8. Could a person be experiencing new burning and shooting pain in their arm

and shoulder if their syrinx has not changed in size Will this new pain

ever go away?

Dysesthetic pain (that is the name of it) is a complex issue. It often

appears when the SM has a CHANGE.

It can be a change of size (increasing or decreasing), or a change of

intrinsic pressure in the face of constant size.

We remind that the size that matters for a SM is the GIRTH, and not its

length.