What is the best management option for my Chiari malformation?

Hello doctor,

I want your opinion about my Chiari malformation shown and described below. I am a 55-year-old female with a history of single major depressive disorder. I had COVID (Corona Virus Disease) almost seven months back. I have had headaches, brain fog, memory loss, falling, neck and ear pain, tinnitus, migraine, and nausea since that time. I had an MRI brain with contrast, and the reading showed an 0.7 inch Chiari type 1. Also, I had MRI (Magnetic resonance imaging) FLAIR (Fluid attenuated inversion recovery) and DWI (Diffusion Weighted Imaging) MRI done. I am meeting my neurologist next week, but I wanted your opinion first. I want surgery to correct this as the migraine medicines do not help, nor do the over-the-counter pain drugs. The radiologist's impression is that I have Chiari 1 malformation; however, no hydrocephalus is seen. Other findings are; that the orbits and mastoid air cells are normal in appearance. In addition, the paranasal sinuses are normal in appearance. A Chiari 1 malformation was seen with the cerebellar tonsils extending about 0.7 Inch below the level of the foramen magnum. The cerebellar tonsils have a pointed appearance as they grow inferior to the foramen magnum. There appears to be slight compression of the adjacent cervical medullary junction. However, the fourth ventricle is in a normal position. There is no acute infarct, hemorrhage, midline shift, hydrocephalus, or abnormal enhancing mass. The corpus callosum is normal in appearance—the pituitary gland is unremarkable T1 sagittal images. I had also done CRP and ESR tests last week, with the values being 21.3 and 46, respectively. I am currently on Synthroid, Cytomel, Pristiq, vitamin D, B12, and Magnesium for restlessness in the legs.