Chiari Decompression
What is Chiari Decompression?
Chiari decompression is a surgical treatment for an abnormal brain condition called Chiari malformation, in which the lowest part of the brain (cerebellum) protrudes into the spinal canal at the back of the skull. This occurs as a result of a structural problem in the skull, where a section of the skull is malformed or abnormally small, pressing on your brain and forcing it downward. The disorder may be present at birth or may develop as the brain and skull grow.
Chiari decompression surgery is also known as posterior fossa decompression surgery and involves removal of a small section of bone at the back of the skull called the posterior fossa to create more space for the brain tissue and relieve pressure on the brain.
Indication for Chiari Decompression Surgery
- Headache typical for Chiari
- Neck pain
- Hearing loss
- Difficulty swallowing
- Upper body weakness
- Loss of sensation of pain or temperature
NOTE: The above symptoms may be caused by a variety of conditions and not just a Chiari malformation
Preparation for Chiari Decompression Surgery
Pre-procedure preparation for Chiari decompression surgery may involve the following steps:
- Discuss the procedure, risks, benefits, and expected outcomes with your surgical team.
- Sign consent form.
- Attend all preoperative appointments and imaging studies.
- Inform your doctor about medications, allergies, and medical conditions.
- Stop certain medications, such as blood thinners, supplements, and fish oil.
- Follow fasting instructions carefully.
- Arrange transportation and support for recovery.
Procedure for Chiari Decompression Surgery
Postoperative Care and Recovery
After surgery, patients are monitored in the intensive care unit for complications such as swelling, bleeding, or neurological changes. Doctors assess speech, movement, memory, and overall brain function. Pain medications and anti-nausea drugs may be prescribed. Imaging scans are performed the next day to evaluate for any operative complications. Recovery time varies, and rehabilitation may be needed for some patients.
What can I expect when I am discharged from hospital
- You may experience pain (including headache), inflammation, and discomfort in the operated area. Pain and anti-inflammatory medications are provided as needed.
- Keep the surgical site clean. Instructions on surgical site care and bathing will be provided.
- Refrain from smoking and alcohol until your first follow up visit as it can negatively affect the healing process.
- Refrain from lifting anything heavier than 5 Kg and other strenuous activities until the first follow-up visit. These activities may include housework, yard work, gardening, mowing, etc.
- Gentle exercise and regular walking are recommended to improve strength and endurance from 2 weeks after surgery.
- Refrain from driving until you are fully fit and receive your surgeon’s clearance.
- Most patients can return to their normal daily routines in 4-6 weeks after surgery.
Risks and Complications
Modern surgical techniques and careful monitoring help reduce the risk of serious complications.
- Post operative blood clot causing pressure.
- Neurological problems such as weakness, speech difficulties, or vision changes.
- Leakage of brain fluid through the wound
- Hydrocephalus (accumulation of brain fluid)
- Reactions to anaesthesia.
- Infection (brain, wound, urine, chest)
- Complications related to other medical conditions (heart, lungs, kidney)
- Clots in legs (Deep venous thrombosis) and clots in lungs (pulmonary embolus)
Note: Your surgeon will advise you on how likely the above complications are.
