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Chiari Malformation
A Chiari malformation is where part of the lower brain sits lower than usual, pushing into the space normally occupied by the spinal cord. Many cases cause no symptoms; others cause headaches and other problems.
Causes & risk factors
- A structural difference present from birth
- A smaller or misshapen space at the base of the skull
- Occasionally develops after injury or other conditions
Common symptoms
- Headache, often at the back of the head
- Headache worse with coughing or straining
- Dizziness and balance problems
- Numbness in the hands
- Neck pain
- Difficulty swallowing
Tests & diagnosis
- MRI brain and spine
- CT scan
- Neurological examination
Treatment & management
- Monitoring if there are no or mild symptoms
- Pain relief for headaches
- Surgery to create more space at the base of the skull if symptoms are significant
- Treating any associated fluid problems
- Regular specialist follow-up
When to see a doctor urgently
- Severe headache with weakness, difficulty swallowing or breathing — seek urgent care
- Worsening balance, coordination or arm weakness
- Headaches strongly triggered by coughing or straining
- New numbness or loss of sensation
Frequently asked questions
Does a Chiari malformation always need surgery?
No. Many are found by chance and cause no symptoms, needing only monitoring. Surgery is considered when symptoms are significant or worsening, and is discussed with a neurosurgeon.
What kind of headache does it cause?
Typically a headache at the back of the head that is brought on or worsened by coughing, sneezing or straining. This pattern in combination with an MRI helps make the diagnosis.
Explore more
Sources & further reading
- World Health Organization (WHO)
- MedlinePlus — U.S. National Library of Medicine
- Ministry of Health & Family Welfare, India
- Indian Council of Medical Research (ICMR)
Reviewed by Dr. Sanjay Anbu, MBBS. MedDroid is an AI medical assistant and can make mistakes. It provides general health information, not a diagnosis or medical advice — always consult a qualified clinician. In an emergency, contact your local emergency number immediately.