Question and Answer Forum

Chiari Malformations and CFS?

By David S. Bell, MD, FAAP

Published in Lyndonville News, March 2000

Question:

Dear Dr. Bell,

I have been hearing about the Chiari Malformation at the base of the brain for the past few months. I understand that surgery may significantly improve CFS symptoms. What are your feelings on this recent area of research?

Answer:

I find the information I have heard concerning the Arnold's Chiari or AC type I malformation intriguing, but I am not familiar with the exact data so I will reserve comment for now.

Like all other new ideas, I hope it will be investigated thoroughly and turn out to have value. One thought, however. It is known that if an experimental animal is maintained with a low blood volume, intracranial hypertension will result. I have suspected that in patients with CFS, a low level of intracranial hypertension exists on a chronic basis, although this has not been proven with a controlled trial. If intracranial hypertension is present, could it push the cerebellar tonsils down into the foramen magnum to look like the AC malformation? It would be very interesting to know of the CSF (cerebral spinal fluid) pressures these patients have at the time of surgery. I am hoping this information will be present when the material is published. For now, I have not been urging my patients to run out and have this surgery right away.

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