Can Neck Injury Be a Causative Agent?
One causative factor in the development of Chiari malformation can be a neck injury. Neck injury is an overlooked mechanism that can be at the root of its genesis. There are many Chiari Malformation Types, as we will discuss in this article, Chiari malformation symptoms are the result of tractioning of the spinal cord. Neck trauma resulting from whiplash-type injury can cause spinal misalignment at the craniocervical junction (CCJ) and be a causative agent in the development of some types of Chiari malformation.
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Whiplash trauma can lead to straight neck syndrome, resulting in a “pulling down” of the spinal cord and combined with other structural malformations of the CCJ can be a causative agent in the pathogenesis of Chiari malformation.
In Dr. Michael Flanagan’s landmark paper, “The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions” he opines that “While further studies need to be done before drawing conclusions, recent research has shown a possible connection between cerebellar tonsillar ectopia and structural strains due to trauma”. (1,2) In this article we will give an overview of what Chiari malformation is, Chiari malformation types, Chiari malformation prognosis, Chiari malformation causes and then discuss a little known procedure called Blair Upper Cervical Chiropractic and discuss how it can help those that suffer from Chiari malformation recover function and health.
Chiari malformation symptoms
Muscular: Headaches, neck pain, muscle weaknesses, problems incoordination, stiff muscles, or overactive reflexes
Sensory: Pins and needles, reduced sensation of touch, sensitivity to light, uncomfortable tingling and burning
Visual: Blurred vision or double vision
Difficulty swallowing, headache, nausea, rapid involuntary eye movement, ringing in the ears, vertigo, or impaired voice
Chiari malformation headaches:
It is very common for patients to suffer from Chiari malformation headaches which result from tethering of the cord. When there is tensile stress on the cord it is common for patients to suffer from headaches. This most likely occurs due to increased intracranial pressure due to the backing up of CSF fluid flow in the brain. Also, the loss of cervical lordosis causes the upper cervical musculature to become spastic as the body attempts to hold the head upright against gravity by contracting the muscles on the back part of the head, lower neck, and upper thoracic spine.
Chiari malformation types
There are four types of Chiari malformations:
Type I. This is by far the most commonly observed type in children. In this type, the lower part of the cerebellum -- but not the brain stem -- extends into an opening at the base of the skull. The opening is called the foramen magnum. Normally, only the spinal cord passes through this opening. Type I is the only type of Chiari malformation that can be acquired.
Type II.This is usually only seen in children born with spina bifida. Spina bifida is the incomplete development of the spinal cord and/or its protective covering.
Type is also known as "classic" Chiari malformation or Arnold-Chiari malformation. In type II Chiari malformation, both the cerebellum and the brain stem extend into the foramen magnum.
Type III.This is the most serious form of Chiari malformation. It involves the protrusion or herniation of the cerebellum and brain stem through the foramen magnum and into the spinal cord. This usually causes severe neurological defects. Type III is a rare type.
Type IV. This involves an incomplete or undeveloped cerebellum. It sometimes is associated with exposed parts of the skull and spinal cord. Type IV is a rare type.
Chiari Malformation Causes and Chiari Malformation Awareness
Chiari Malformation causes can be many and are usually the confluence of many different factors that lead to its development. Chiari malformation awareness has grown in recent years with advanced imaging showing the existence of the syndrome in a higher percentage of cases than previously thought. There are many structural malformations of the skull and upper cervical spine that make these individuals more susceptible to developing Chiari malformation.
However, in this article, we would like to focus on acquired Chiari Malformation and the effects of cervical spine trauma have in its development. There is a sub-sector of people that suffer from Chiari Malformation that results from neck trauma and the cascade of effects that can stem from it. As we eluded to at the beginning of this article, neck trauma can cause atlas and or axis misalignment that alters the neurophysiology of the body first by changing the structural integrity of the spine due to postural muscle tone changes.
People who have structural malformations such as, abnormal clivoaxial angle, hypoplasia of posterior fossa, platybasia, basilar invagination, and other anomalies that result in overcrowding of the back part of the brain, make these individuals more susceptible in developing Chiari malformation. Couple structural anomalies with misalignment of the cranial cervical junction due to whiplash injury and the perfect storm exist to develop Chiari Malformation syndrome.
What Does An Upper Cervical Chiropractor? Understanding How Blair Upper Cervical Can Help Those That Suffer From Chiari Malformation
Blair Upper Cervical Chiropractors are well-trained specialty doctors who focus ALL of their attention on the relationship of the skull, atlas, axis, and their relationship to the brainstem and associated spinal nerves. The Blair Upper Cervical Doctor runs a battery of tests to locate spinal cord pressure and interference resulting from spinal misalignment.
Once the patient is determined in having spinal misalignment precise imaging is taken to using cone beam computed tomography (CBCT)or digital x-ray to visualize the joints and how they fit. Each joint in the upper cervical spine fits as a mirror image with the other. If spinal misalignment exists by viewing each joint the doctor can determine exactly how the vertebrae have misaligned from normal and determine the angulation of the joint.
This information, which is unique to each individual, is then used in making a precise spinal correction without using any twisting, popping, or pulling. The goal of the care is to stabilize the biomechanics of the upper cervical spine, so the central nervous system can function without structural interference. The correction of the upper cervical spine allows the central nervous system to function more normally.
Once corrected the spine will strive towards better posture, cervical curve loss will correct towards a more normal lordosis, in doing so pressure and strain on the spinal cord are relieved and more normal function ensues. Chiari malformation decompression is a surgical attempt to increase space at the skull neck level. Before going through such drastic neurosurgery, it would be advisable to see if upper cervical care can be used as a natural means of avoiding surgery and naturally reducing pressure and spinal cord interference at the CCJ (craniocervical junction).
Correcting the upper cervical spine is not only good for Chiari malformation sufferers but is also a health care procedure that should be used by everyone to ensure proper nervous system function. If you or a loved one sufferer with Chiari malformation our office offers a FREE consultation where you can have your questions answered and go through an exam that will determine whether your case can be helped or not.
To schedule you can call 310 324-6172 for our Carson office or 213 399-7772 for our Los Angeles office.
If you are outside of the Los Angeles area you can call our office and we would be happy to find you an upper cervical doctor in your location.
- Freeman M. D., Rosa S., Harshfield D., et al. A case-control study of cerebellar tonsillar ectopia (Chiari) and head/neck trauma (whiplash) Brain Injury. 2010;24(7-8):988–994. doi: 10.3109/02699052.2010.490512.
- Damadian R. V., Chu D. The possible role of cranio-cervical trauma and abnormal CSF hydrodynamics in the genesis of multiple sclerosis. Physiological Chemistry and Physics and Medical NMR. 2011;41(1):1–17.