Saturday, January 16, 2010

Arnold Chiari Malformation

What exactly is Arnold Chiari Malformation??

I am going to make an effort to try and explain ACM, it is somewhat complicated but I'm going to try and just give an overview.

There are actually several types of ACM. Type II is specific to Spina Bifida so that is what will be discussed here. ACM II is a complex brain malformation that almost all (85-90%) children with Spina Bifida have. ACM II involves the lower brainstem, upper spinal cord, and the cerebellum. The brainstem connects the brain and the spinal cord. It controls basic functions like breathing, blood pressure, body temperature, the heart, hunger, thirst, swallowing and even sleep patterns. The cerebellum controls balance and the coordination of muscle movements. In ACM II there is a downward displacement of the cerebellum, as well as the medulla and fourth ventricle. The fourth ventricle is elongated and is pulled down into the cervical area of the spinal cord. This is what blocks the flow of cerebrospinal fluid, leading to hydrocephalus.

I know it sounds complicated and it can be very overwhelming, and perhaps a little scary. It's important to know about ACM II because it is something that affects are kiddos. Your child may or may not have any symptoms of ACM II but it is good to know what to look for just in case. ACM II is the reason some of our kiddos have feeding and/or swallowing issues, and even reflux. ACM II can also cause apnea. Some will show signs of stridor, a high-pitched sound when breathing. ACM II can even cause weakness in the arms and hands.

Even though almost all of our kiddos have ACM II, they may only show very mild symptoms or even no symptoms at all. I just think it is important to know about ACM II so that if your child does have any of these above issues, you will know what could be causing it. My son Caleb has some balance issues and is fearful of falling and I believe it is likely due to ACM II. His body temperature also fluctuates and I believe ACM II could be the cause. We tend to focus on the physical limitations of Spina Bifida and forget about the huge affect it has on the brain. Our kiddos brains are different and it's important to know what that means for their development. I am always surprised to learn that many parents of kiddos with SB have never even heard of ACM II, their doctors have never mentioned it. Hopefully this has given you a little information about it. Knowledge is power...right?

I found this really cool website that gives a great overview of the brain.


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