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Cerebellum Prolapse (Arnold Chiari Syndrome)

What Is Cerebellum Prolapse?

It is the herniation of the extensions of the cerebellum, called tonsils, from the opening at the base of the skull (foramen magnum) to the spinal canal. Herniated tissue affects the circulation of cerebrospinal fluid, leading to complaints. Accordingly, cerebrospinal fluid may accumulate in the brain (hydrocephalus) or spinal cord (syringomyelia).

Type 1: It is the cerebellum compression caused by the small back of the head. This can be seen in both adults and children. It is the most common type of Arnold Chiari Syndrome and can cause a cyst in the spinal cord.

Type 2: Occurs during childbirth and especially affects babies. It occurs together with spina bifida, which is an abnormality of the spinal cord. If the spine is not closed before birth, it is the case that the spinal cord protrudes like a sac in the non-closing part.

Type 3: It is rare and occurs mostly in infants with the formation of a fluid sac on the back of the baby's neck. This is a birth defect called encephalocele.

Type 4: It occurs in babies when the cerebellum does not develop properly.

What Are The Symptoms of Arnold Chiari Syndrome?

Symptoms in adults can be listed as follows:

Neck pain
Numbness in hands and feet
Difficulty swallowing
Hearing loss, ringing in the ears
Loss of sensation in the trunk and head area
Curvature of the spine
Loss of equilibrium
Symptoms in infants can be listed as follows:
Eating problem
Ingestion problem
Eructations, vomiting
Irregular breathing
Deceleration of body development
Weakness in arms
Growing in the head
Epilepsy crises

How Is Cerebellum Prolapse Disease Treated?

Treatment varies according to the type, severity and symptoms of sagging. Some medications may be prescribed for mild pain that does not greatly affect daily life. If the disease is causing serious symptoms or damage to nervous tissues, surgical treatment is required. The type and number of surgeries needed depends on the patient's condition.

In adults, brain sagging surgery is performed by cutting off a part of the skull bone. Then, the exposed part of the brain is closed with tissue taken from another part of the body. This allows more space for the cerebellum and brain stem, relieving pressure on the spine. If needed during surgery, cerebellum tonsils are reduced using electrical current. It may also be necessary to remove a small portion of the spine to provide more space.

With surgery for babies and children, congenital defects such as spina bifida and encephalocele accompanying cerebellum prolapse are treated. Surgery is performed to reposition the spinal cord and close openings in the neck or back. If there is hydrocephalus, a tube is inserted to drain excess fluid from the brain to reduce intracranial pressure. The surgical procedure is performed to alleviate the severity of the symptoms.

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