Why do Chiari malformation patients have headaches?

Question

Hi doctor,

I was diagnosed with Chiari malformation and underwent decompression surgery 10 years back. I also underwent two ACDF surgeries, of which one was performed eight years back, and one more surgery was performed six years back. I am experiencing headaches, neck pain that is radiating to my shoulders and arms, back stiffness, and visual disturbances, for the past few months. I am taking tablets Gabapentin, Hydroxyzine, and Flexeril. A recent MRI scan showed that there are postsurgical changes, mild crowding of the posterior fossa, and extension of the bilateral cerebellar tonsils to the level of the basion. It also states that principal intracranial arterial flow voids are present. What does this mean?

Kindly give your suggestions.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I suggest you answer the following questions to know further details about your headache :

1. When did you start having headaches and neck pain?

2. Which part of the head is aching?

3. Which part of your neck is paining?

4. What kind of headache do you get, heaviness, bursting, squeezing, stretching, throbbing, or some other kind?

5. What kind of pain do you feel in the neck and the arms, stretching, heaviness, pulling, electric current-like sensation, burning, tingling sensation, or something else?

6. Are your headaches are intermittent or persistent?

7. Do headaches and neck pain occur simultaneously or at different times?

6. If intermittent, what is the time duration for one episode of headache, without a painkiller tablet?

7. Do you experience nausea or vomiting during headaches?

8. Does headache cause redness or watering from the eyes or nasal blockage?

9. Have you noticed any specific trigger factors for headache and neck pain such as mental stress, fasting, sleep deprivation, neck movement, any particular food or smell, bending the neck forward, lifting a heavy object, or something else?

10. How frequent are these headaches? How many times do you get in a day or week?

11. Do you take any medications during headaches and neck pain?

12. What is the dosage of the tablet Gabapentin that you are taking? And are you feeling better after taking this tablet?

13. How is your vision for distant objects and near objects? Does it get better with spectacles?

14. How is your sleep routine? Do you get to sleep soon after lying in bed, or does it takes a long time? Do you often wake up during sleep? Do you feel fresh after waking up in the morning?

15. How is your mood in day-to-day activities? Do you feel happy or sad?

16. How is your appetite?

Kindly follow up with the answers.

Thank you.