To understand how chiropractic can help with an Arnold Chiari malformation, it will help to discuss the normal anatomy of the brainstem first. The brain effectively “floats” in a liquid called cerebral spinal fluid, or CSF. This fluid surrounds the brain and spinal cord and has a number of functions including being shock absorber, circulating chemicals and nutrients and waste removal. The brain stem, including the cerebellum, comes out of the base of the skull in the foramen magnum.

In cases of an Arnold Chiari malformation, the brain stem and cerebellum sit to low in the foramen magnum. This puts pressure on the cerebellum and can increase the CSF pressure in the brain. Two things you definitely don’t want to happen. This can cause balance issues, coordination issues, and very commonly pain in the base of the neck/head that increase with activities that increase pressure in the brain such as coughing and sneezing.

There are 4 types of Arnold Chiari Malformations, or ACM:

Type I

In this instance only the cerebellar tonsils (a small part of the cerebellum) extends into the foramen magnum. An MRI is needed to diagnose. This is by far the most common cause and in some instances causes no symptoms. However it can cause headaches, neck pain, balance/coordination issues and other symptoms. In many instances this will be seen after a trauma such as a car crash. Clinically we see these patients tend to have more severe symptoms and take longer to respond to care.

Type II

This typically appears in childhood and is when both the cerebellum and tonsils go through the foramen magnum. This can be a life-threatening condition and may require surgery.

Type III

This is very rare and the cerebellum and brainstem will stick out through a hole in the back of the head.

Type IV

In this case the cerebellum will be incomplete or not fully developed. This is another rare form.

In chiropractic, we focus on treating Type I. Very frequently we treat these patients after a car crash or when they have a history of severe headaches and neck pain.

Cheers,

Dr. Paul Fisher