Re: Herniation or Compression

[Guest guest]

HI all,

Not to confuse anyone any more, But while we are on this topic of the

tonsils.

Dr. Milhorat, said my tonsils were descending " outward " kind of like slumping

out of the hole that was made for my decompression. Strange huh???

First they were pulled down in the spinal cord, now they are falling out the

back of my head. GO FIGURE??? He seems to think my duraplasty is not holding

my brain in, So,

back to the same old question everyone keeps asking ( I cannot believe I

didnt think of this before) Even if you keep making more room for the

brain, or in my case, a titanium plate so it wont " slump " , Will it not

still keep going down and down

Shouldn't we tack it, or tie it, glue it, maybe even tape it J/K lol... I

use humor to escape

insanity....... chiari has my head spinning........ physically and mentally

Love you guys............ Love, In GA

[Guest guest]

a few thoughts on issues related to compresion and herniation .

one aspect of dura graft , is to allow more room for the tonsils to expand

into ....this allows for better csf flow ....another is to sew the graft , in

such a way that it acts as a sling or hammock , helping to keep them up . yet

another is , there can be tough fiberous bands at the level of the foramen

magnum , difficult to see unless the dura is opened ....when these are

present , then without their removal ...., you may see continuing problems .

not all doctors do a graft .....and ive no idea in these cases , how they

deal with the above .....rather confusing .

if a cervical meduallary kink is seen on mri ...its more likely those tough

fiberous bands may be present .....so in my mind , id be looking for a

neurosurgon who addresses how he plans to deal with the kink .....

tonsils usually dont drop lower , following surgery ....unless other things

go wrong too ....and typically may go back up a tiny bit , in responce to

more room ....but often stay at the same level ....that is partly what helps

determine how many vertabrae may need lamenectomy ect ...you want a wide

enough , long enough channel cut in the bone rings , to avoid compresion on

em .

tonsil tissue is occationally seen to be dammaged from compresion ,

esentially dead ....in this case many neurosurgeons chose to cautherise it

,...burning it away to help open a better pathway ...as it wont heal or

regenerate .....one large study on this , was published on the net , done in

japan ....with very good results .

tonsils are not known to have a function ( no one is sure why they exist )

.....but patients who have had em completely removed , have done well

......most us neurosurgeons dont remove them completely ....only zap em to

prod em up a bit ....or burn obviously dammaged bits off ect . its imposible

to see this all , through that dura .

a couple disadvantages of dura patch , include leeks ....and occationally

during surgery , a small bit of blood can get into the csf , causeing

chemical meningitis ......

the texture of dura , has been likened to plastic wrap , and to jello ..( 2

different neurosurgeons ....) ...either way ...plastic wrap when pierced with

a needle , can allow for leeks ...jello when pierced , will leave a small

tract behind , for csf to work its way through ....increased presure , may

cause either to leek more .....these tiny holes , often seal over within a

day or two ....hense , the advise after lumbar tap , stay flat a day or so

.....helps prevent that increase in presure .

soo ....rambling thoughts here ....and not appropriate to all neurosurgeons

ways of doing things ......for example , Dr Milhorat doesnt open the dura in

many cases ....some others always do ....not all of us start with the same

situation .

some bits of what i wrote , like the fiberous bands , are more likely to be

present with acm 2 ....but scaring and arachnoid adhesions may be present

with either .

before chosing surgery , do learn just what that surgeon believes , and

proposes to do ....not all are the same in approach and belief ...its TRULY

important to understand what they propose .

my 10 cents ....

sarah in paradise

[Guest guest]

I'm not in any way trying to limit discussion here. That's how we all

learn.....

I do think that it is important to remember, that there are quite

possible NOT absolute answers to these questions (and many others) at

this time. I also believe that everyone's " chiari situation/ cause/etc "

is not the same. I feel that as more is learned about this subject ( and

we can only hope that it is) that there will be be different causes,

symptoms, and hopefully also fixes!!!

Sally R ACM.. decompression '91...Hydro...doing well in Bethlehem,Pa

Sandy Loges wrote:

> Hi All, this is such a great subject I can't leave it alone. So the

> space is not large enough so the tonsils herniate downward,Right? But

> is it right to say since the tonsils have pushed down from too little

> room that they(tonsils) will not go back to normal after surgery to

> make area larger? And the only cause of herniation is too small of a

> space and not a deformaty of the brain itself. Hugss Sandy

>

> He

[Guest guest]

That's my understanding. Whit's tonsils were cauterized to make them

" shrink " therefore also giving a little more room. It is a deformity of the

skull itself. THe opening made by her nsg was to make it the size it

should be and relieving the pressure that the herniation made on her

brainstem and spinal cord.

Herniation or Compression

> Hi All, this is such a great subject I can't leave it alone. So the

> space is not large enough so the tonsils herniate downward,Right? But

> is it right to say since the tonsils have pushed down from too little

> room that they(tonsils) will not go back to normal after surgery to

> make area larger? And the only cause of herniation is too small of a

> space and not a deformaty of the brain itself. Hugss Sandy

>

>

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