Chiari malformation is a condition in which the bottom part of the
cerebellum (a smaller part of the brain) hangs down into the foramen
magnum. The foramen magnum is the largest exit hole from the inside of
the skull. It is the hole where spinal cord exits. It is sometimes
associated with those symptoms that you describe in your message. The
treatment for this condition is surgery. The surgery involves removing a
portion of the skull and the upper cervical vertebra to widen the foramen
magnum and perhaps create more space for that portion of cerebellum that
squeezed into the space where spinal cord alone had its claim. The
symptoms are frequently vague, i.e. headaches, pain in the arm, worsened
by coughing, rare blackout spells. The indication for surgery is rather
straightforward if you have any evidence of high intracranial pressure,
compression of brain stem (upper part of the spinal cord), with long tract
signs (evidence that information is not passing in upward or downward
direction). These evidences can only be detected by detailed history and
physiccal examination. The surgery is also straightforward.
I have a problem with this condition because I have no idea how or why
this developes (except for a lot of theories) nor is there any reason why
this operation works. Fortunately the surgery is usually effective at
least to stop the progression or to relieve certain symptoms.
You also have to consuder other associated conditions such as
hydrocephalus and syringomyelia.
If you have a problem with your doctor, get another one to talk to you.