Chiari Malformation in Children
Chiari malformation is a structural brain condition that affects children of all ages — including infants. At Advanced Neurosurgery Associates, our pediatric neurosurgery team provides specialized care for children across New Jersey, helping families understand their diagnosis and access the right treatment as early as possible.
Due to technological advances and a list of significant advantages, minimally invasive surgical techniques have been commonly used for spine surgery since the 1990s. Today, highly skilled neurosurgeons in New Jersey continue to refine and perform these procedures to improve patient outcomes.
What Is a Chiari Malformation?
A Chiari malformation occurs when brain tissue extends into the spinal canal. This happens when the space at the base of the skull is too small, causing part of the cerebellum — the section of the brain that controls balance and coordination — to push downward through the opening at the bottom of the skull (the foramen magnum).
There are several types, but Type I is the most common in children and is often diagnosed in school-age kids or adolescents. Type II, also called Arnold-Chiari malformation, is typically present at birth and is frequently associated with spina bifida
Symptoms in Children
Symptoms vary depending on the child’s age and the severity of the malformation. Parents should watch for:
- Frequent headaches, especially at the back of the head that worsen with coughing or straining
- Neck pain or stiffness
- Balance problems or difficulty walking
- Difficulty swallowing or feeding (especially in infants)
- Weakness or numbness in the arms or hands
- Vision or hearing disturbances
- Delayed developmental milestones
In some cases, Chiari malformations are discovered incidentally during imaging for an unrelated concern. Not all cases require immediate treatment — but all require careful monitoring by a qualified specialist.
Diagnosis
Diagnosis begins with a thorough neurological evaluation and is confirmed through MRI imaging, which provides detailed views of the brain and spinal cord. Our team may also order additional imaging to assess for associated conditions such as syringomyelia (fluid-filled cavities in the spinal cord), which occurs in a subset of children with Chiari malformation.
Treatment Options
Treatment depends on the type, severity, and symptoms. Options include:
Watchful Waiting :
For children with mild or no symptoms, close monitoring with periodic imaging may be appropriate.
Surgery – Posterior Fossa Decompression
For children with mild or no symptoms, close monitoring with periodic imaging may be appropriate.
Our surgeons take a conservative, individualized approach — recommending surgery only when the clinical picture supports it and the benefits clearly outweigh the risks.
Pediatric Neurosurgery Care Across New Jersey
Advanced Neurosurgery Associates serves families throughout New Jersey from four convenient locations in Rutherford, Jersey City, New Brunswick, and Morristown. Our team has extensive experience treating complex pediatric brain and spine conditions, and we work closely with referring pediatric neurologists to ensure seamless, coordinated care.