- Chiari 0

[Guest guest]

Hi ,

This is a site I have bookmarked:

http://www3.sympatico.ca/ejfs/chiari0.html

Did a quick look around and a lot has been added since the last time I visited

this site.

's mom

Re: Re: Question for Kathy and Tethered Cord and Chiari

I haven't. I've looked at research done in

Neurology/Neurosurgery journals, but most of the

abstracts don't mention anything about a bone issue.

When did the definition change? I was tested for ACM

about 6 years ago due to some symptoms, but was found

not to have it. Then people started discussing ACM 0,

which many docs, I guess, aren't accepting as really

ACM. I did much of my research before 2004, and if it

has been redefined to break what was traditionally ACM

down into more categories, I'd love to read about it

if you could point me to a journal.

--- charneloj wrote:

> Yes I agree a tethering can cause ACM or symproms

> like it if you go by

> the older definition of it. Have you read Chairi

> redifined by Dr

> Milhorat? It is the beginging basis for looking at

> chiari and its

> causes. TCI will be publishing another study soon.

> I guess it would

> be more precise to say a bony anomaly causes chiari

> to occur. What I

> was trying to get across is again accuracy in

> labeling. The tonsils

> poking out of the foramen magnum is called

> cerebellar tonsil ectopia.

> This can be caused by tension from tethering of the

> spinal cord in

> any form. The problem with the older chiari

> definitions is that they

> are not precise and label tonsil ectopia of all

> causes whether they

> are in the skull anatomy (adding the resulting

> cerebellar compression)

> or caused by lower tethering. They cannot be

> treated the same way and

> in the more advanced treatment facilities are not

> being labeled

> together. Where we go for treatment they do not

> look so much at the

> ectopia but at the structures around them and the

> causation of

> symptoms. If you looked soley at the older

> definitions they do not

> take into account what the tonsils are doing they

> just look at the

> lenght of the ectopia. There are people walking

> around that have

> herinations of 20mm that have no problems and people

> who have Chiari 0

> who are completly disabled. It would be nice if ACM

> I and ACM II were

> not defined so much by the presence of spina bifida

> but by the

> structures of the skull and the presence of

> tethering. I was

> inprecise in my earlier post you are responding to.

> I was refering to

> ACM I and the newer difinition of it as I understand

> it. I have not

> had a chance to study the newer research on ACM II

> and how it relates

> to the deformity of the skull if there is any. The

> problem with a lot

> of the chiari studies talking about " aquired " ACM

> and " temporary " ACM

> is that they are only referring to tonsil ectopia.

> It would be easier

> if they called it aquired tonsil ectopia or

> something. With chiari it

> is difficult becuase everything they knew until a

> few years ago was

> learned from autopsy and visual assesment if it

> during surgery. With

> the testing available today you can see the

> strucures in three

> dimensions and from any view you want. By looking at

> the structures

> you can sometimes find the root of the problem.

> Look at Chiari II.

> If the tethering is fixed does it resolve the

> ectopia or are is it the

> structures of the skull where there is an additional

> issue compression

> due to lowered posterior fossa space? I do not know

> of any research

> that addresses these issues for Chiari II as the

> study Dr M did for

> Chairi I. It is difficult for me to recreat my

> research trail but I

> will look back and see what I can find.

> Charnel

>

>

> >

> > > Chiari malformation is the malformation of the

> > > inferior occipital

> > > bones compressing the hindbrain. The type of

> > > adheasion tethering seen

> > > in spina bifida may or may not have an effect on

> the

> > > hindbrain but it

> > > is highly unlikely that it or filum tethering

> could

> > > cause the bones in

> > > the back of the skull to malform in the way

> noted

> > > with arnold chiari

> > > for several reasons. The bony malformation of

> > > chiari creates a space

> > > that is smaller. If inferior tension to the

> > > hindbrain from tethering

> > > was going to cause change in the bony structor

> it

> > > would be in the

> > > direction of the pull not the other way. Such

> > > change would increase

> > > total occipital hindbrain room. While chiari

> and

> > > tethered cord are

> > > seen together and can exacerbate or mimic the

> > > other's symptoms there

> > > are certain conditions which have to be present

> for

> > > them to be dxd

> > > together. Mere tension on the cord causing

> > > compression of the

> > > hindbrain does not make chiari a result of

> tethered

> > > cord. If that

> > > were true it would be the chicken and the egg.

> What

> > > do you treat to

> > > fix the other. A true expert in chiari and

> tethered

> > > cord should

> > > recognise the difference in downward distention

> of

> > > the brain due to

> > > tethering versus the cerebellar space issue

> created

> > > by a bony

> > > malformation being complicated by tethered cord.

>

> > > Tethered cord cannot

> > > cause chiari but can mimmic the symptoms

> present.

> > > Muck like a mina

> > > bird can spit out phrases but does not know what

> it

> > > is talking about.

> > > Charnel

> > >

> >

> > __________________________________________________

> >