Chiari Malformation Ireland

Hebron boy faces brain surgery

2010-08-29T12:31:00.000+01:00

Like many 10–year–old boys, Jordan Minder loves sports. He loves playing football and soccer. He loves watching the Chicago Blackhawks, the Chicago White Sox and WWE wrestling......

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Calne girl thanks hospital that saved her life

2010-08-11T13:54:00.000+01:00

Calne girl thanks hospital that saved her life

Wednesday 11th August 2010

By Alex Winter »

Plucky Kat Muscroft is taking part in a sponsored walk, swim, and silence to raise money for the hospital that twice saved her life.

Ms Muscroft, 20, of Oxford Road, Calne, has had five brain operations at the John Radcliffe Hospital in Oxford since January.

She suffers from Arnold Chiari Malformation, which causes the skull to crush the brain. Symptoms include severe headaches, muscle weakness, and nausea.

She said: “I want to do these events for the hospital because they’ve saved my life and the life of my friend Dan Winter, who was hit by a car last May.”

Childhood friend Mr Winter was recently back in the hospital’s intensive care unit after suffering an epileptic fit.

“I nearly died during two of the operations,” said Ms Muscroft. “I was really scared when I found out what was wrong with me and why I had such bad headaches.”

Ms Muscroft also learned she had hydrocephalus, water on the brain, and tachycardia, a rapid heart rate, which led her to pull out of a sponsored bike ride on Sunday.

She has already raised £900 of her £1,000 target and will be joined on her triple test by mum Anita, dad Barry and sister Rebecca Weinling, as well as her niece, step-nieces and her brother-in-law.

“About ten of us are doing the walk, and we’ll all be in fancy dress,” she said. “I’m going as Tinkerbell, my family are pirates and a friend is Noddy.”

Her four-mile walk is on Saturday with her 25-metre swim the next day and a 12-hour silence on Monday.

To sponsor her, email kat070490@aol.com

2010-08-09T19:20:00.000+01:00

New Study Finds Whiplash May Cause Anatomical Changes to Brain

Dr. Ezriel E. Kornel Co-Authors Groundbreaking Article in Brain Injury Journal

FOR IMMEDIATE RELEASE

PRLog (Press Release) – Aug 09, 2010 – (White Plains, NY)… While it has long been known that whiplash can cause injuries to the cervical spine, a new study published in the July issue of the journal Brain Injury shows that whiplash may also cause anatomical changes to the brain.

According to Dr. Ezriel E. Kornel, M.D., F.A.C.S., a principal with Brain & Spine Surgeons of New York in White Plains, and a co-author of the Brain Injury article, “The study examined the MRI scans of 1200 neck pain patients and found that those patients suffering from whiplash were more likely to have anatomical changes to the brain, specifically, a herniation of the brain called Chiari malformation, in which the bottom part of the brain (the cerebellum) dips through an opening in the base of the skull.”

This condition can be quite painful and endanger the patient’s health, with symptoms that may include headaches, neck pain, upper extremity numbness and tingling, and weakness. In a few cases, there can also be lower extremity weakness and brain dysfunction. Dr. Kornel advises anyone suffering from whiplash to see a physician immediately.

Dr. Kornel will discuss his latest findings about whiplash on his WOR-AM radio show, “Back Talk Live,” a call-in medical show devoted to back and neck pain, and brain disorders. “Whiplash: More Than Just a Pain in the Neck” will air on August 15 at 7:30 pm. (podcast available at www.backtalkliveonair.com). Dr. Kornel’s guest will be Dr. Michael D.
Freeman, associate professor in the Public Health and Preventive Medicine Department at Oregon Health and Science University and the lead author of the Brain Injury journal article on whiplash.

The other co-authors are: Scott Rosa, David Harshfield, Francis Smith, Robert Bennett, Christopher J. Centeno, Ake Nystrom, Dan Heffez and Sean S. Kohles.
A summary of the Brain Injury journal article can be found online at: http://informahealthcare.com/doi/abs/10.3109/02699052.20 ...

About Ezriel E. Kornel

On the board of directors of the American Association of Neurological Surgeons, Dr. Kornel has been a principal of Brain & Spine Surgeons of New York since 1990. He is a leader in minimally invasive endoscopic surgery of the spine as well as minimally invasive approaches in the surgical treatment of brain tumors. He was trained in Stockholm in the use of the Gamma Knife, and, when indicated, utilizes this stereotactic technique for the treatment of brain tumors as well as the treatment of trigeminal neuralgia.

Dr. Kornel is board-certified by the American Board of Neurological Surgery and is a fellow of the American College of Surgeons. He has a clinical academic appointment in the Columbia University Department of Neurosurgery and was formerly an assistant clinical professor in the Yale University Department of Neurosurgery.

Dr. Kornel is a current board member and past president of the New York State Neurological Society. He is a New York delegate to the Council of State Neurological Societies and is on the board of directors of the American Association of Neurological Surgeons.

In addition to serving as director of the Institute for Neurosciences at Northern Westchester Hospital, Dr. Kornel is affiliated with some of the leading hospitals in Westchester and Fairfield counties.

Dr. Kornel gained his initial expertise during his neurological residency at the George Washington University Medical Center under the tutelage of Hugo Rizzoli, M.D., at the time one of the most renowned and respected neurosurgeons in the world. He has authored many scientific articles relating to neurosurgery and has written a chapter in an online textbook regarding management of cervical spine trauma. Involved in the early development of instrumentation to allow for endoscopic and minimally invasive spine surgery techniques, Dr. Kornel is the inventor of instrumentation for percutaneous spine fusions with a patent pending.

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UL youth overcomes big hurdles

2010-08-08T08:33:00.001+01:00

UL youth overcomes big hurdles

Kaden Koscoe is your normal 7-year old.

He loves hanging out with his friends, playing baseball and he's not looking forward to going back to school.

However, there's so much more to the Union Local second grader that you'd never know.

Just two years ago, Koscoe was diagnosed with a rare neurological disorder called Chiari Malformation, which affects just 300,000 people in the United States.

"It's a brain condition, which causes many symptoms," said Kaden's mother Kara. "It affects all of your fine motor skills."

According to his mom, Kaden was "kind of delayed" as a baby in terms of talking or walking.

"It was nothing that set any alarms off for us as parents," Kara said. "He finally got those things and was keeping up, so it didn't send any red flags up for us."

The disorder - which most are born with - was discovered when Kaden was having trouble eating and was then experiencing severe headaches.

"We took him to the doctors and they decided to do a MRI," Kara said. "He was really specific about the headaches being behind his eyes and it was from all of the pressure on his brain."

After looking at the results of the MRI, the doctors here in the Ohio Valley sent Kaden to Nationwide Children's Hospital in Columbus for further examination.

"It was horrible to hear the news," Kara said. "As a mom, I had a feeling that something wasn't right, but you pray that everything was okay. When his doctor at Wheeling Hospital called us and said he needed us to come to his office, it was just a severe sick feeling in your stomach."

Within a month of his referal, it was deemed that Kaden would have to undergo a five-hour brain surgery to relieve the pressure on both the brain and spine, which is caused by the cerebullum descending out of the skull toward the spinal cord.

"The surgery isn't a cure," Kara said. "That surgery felt like a lifetime because we just sat in a waiting room. It was the hardest thing I had to do because I got to walk him down the hallway just before they put him under anesthetic."

The family received constant updates from the operating room.

"The nurse called us all the time and the neurosurgeon said, 'Mom, it's okay to be nervous,'" Kara said. "It was a critical surgery and one little slip up could have been it."

Kaden returns to Columbus every three to six months depending upon the results of the MRI, which lasts upward of an hour. Kaden's next appointment is scheduled for the middle of October.

"We see a wonderful neurosurgeon (in Columbus) named Dr. (Edward) Kosnik," Kara said. "If the doctors see something they don't like on the MRI, we've got to go a little more often."

According to Kara, additional surgeries are still a possibility as he continues to grow older.

"We pray that he doesn't, but it's a little nerve-wracking because you never know what the MRI is going to say," Kara said. "Everytime he gets a headache I panic probably more than the normal parent would. An alarm goes off for me."

Kaden's parents haven't hidden anything about his disorder from him.

"He understands and he does wonderful with it," Kara said. "He used to have to be put to sleep for the MRIs, but he's gotten to be such a pro at it he gets to watch a movie while he undergoes it. He's a brave boy."

As he gets older, the check-ups will continue, but they will be spaced out further than every three months.

"We're hoping that if we have a good check-up this year, Kaden's check-ups could actually go to every six months or a year," Kara said.

Kaden was actually back in the hospital in February due to extreme back pain.

"The doctors thought it was caused by the spine starting to heal," Kara said. "He can feel his spine healing, which is what the pain is from, so he was in the hospital for a few days for that, but everything's been fine since."

Other than the routine check-ups, doctors have cleared Kaden to do basically everything other kids can do.

"The doctors have told us to let him be a kid," Kara said. "If I could put him in a bubble, I would, but we're letting him be a kid. I admit that's hard for me at times, but we've learned what to look for."

Part of being a kid is playing baseball and Kaden is the catcher for the Union Local Pinto All-Star Team, which is coached by his dad, Andrew.

"I want to shed a tear each time he takes the field because I never thought I'd be able to see the day when he got to do something like this," Kara said.

Kaden actually approached his dad about coaching his team this year after watching him coach his older brother Austin's team for several years.

"I really had no intentions of coaching, but when he asked we got some of his buddies and put together an all-star team," Andrew said. "Kaden's starting to learn (about baseball) more and he's a hustler. He's getting a lot better."

Kara and Andrew have become advocates of raising awareness and funds for research for Chiari 1 Malformation.

The couple is currently planning to host its second annual walk at Barkcamp State Park on Sept. 18, which is part of The Conquer Chiari Walk Across America, which is based in Wexford, Pa. The entire event raised $250,000 a year ago.

Registration for the walk is at 11 a.m. with the walk beginning at noon.

"Our goal for our walk this year has been set at $10,000," Kara said. "We got involved last year and got improved as a site and organizer. I'm excited to say with the funds they've raised the last two years, 90 percent of it has gone for research."

As word of the walk has spread, the Koscoe's have encountered others in the immediate area who've been touched by Chiari Malformation.

To begin raising funds, they decided to sponsor an all-star baseball tournament and fittingly named it "The Kaden Classic." The tournament wraps up today at Schuler Park in Flushing.

"I told my husband what a better way to raise money for the walk than do something he loves," Kara said. "So, we came up with this idea and we're so happy how many other teams got involved."

All told, 11 squads entered the tournament, which began Thursday evening.

"I am excited that so many people have come and helped with something that's helped me," Kaden said. "I like baseball because of hitting and catching the ball. I want to try some other positions like shortstop or second. I really like baseball."

"From the time I heard the news and thinking the worst to then hearing a doctor clear him to play sports and be a normal kid is just wonderful," Andrew said. "I think it's good for our self-esteem and his and puts us at ease a little bit. It's great we've been able to have the entire county and Ohio Valley come together for this tournament with some great sponsors. We're planning on making The Kaden Classic an annual event."

Kaden - who is a Pirates and Indians fan, but says Albert Pujols is his favorite player - has received occupational and physical therapy through Union Local, but has since been cleared.

"He's always been in a regular classroom, but he's received some therapy for the fine motor skills," Kara said. "He's been cleared to be perfectly normal."

If you'd like to participate or sponsor the walk, please contact Kara Koscoe at 740-310-7915 or by email at koscoe36@yahoo.com

Staskey can be reached at sstaskey@timesleaderonline.com

Times Leader Online.com

2010-07-24T18:50:00.000+01:00

Community steps up to help Knowlton girl with rare spinal condition

Published: Saturday, July 24, 2010, 9:56 AM

Story Written By Jane Primerano

KNOWLTON TWP. — While most 11-year-old girls like to show off their spelling skills, Cathleen Balla has a talent for impressive words.

Unfortunately, that’s because they describe a serious disease that is impacting her life.

“That’s Cathleen with a C,” the bouncy blonde said before spelling the ailment: syringomyelia, or SM, a tubular cyst in the central spinal canal. Going along with SM is a Chiari malformation, a structural defect in the cerebellum, the part of the brain that controls balance.

Cathleen has suffered back pain, headaches, pressure behind her eyes and fatigue for three years. Her doctor, Eugene Cullen of Skylands Medical in Blairstown, suspected SM, but Children’s Hospital in Philadelphia found nothing wrong, her mother, Sara, said. The Shriner’s Hospital in Philadelphia confirmed SM.

Nothing can correct any damage that’s been done, but surgery may stop the progression of the disease, which can include glaucoma and bowel and bladder problems. In the U.S., multiple surgeries are performed and insurance won’t pay for any surgery at the stage Cathleen is now.

The Ballas discovered an institute in Barcelona where laser surgery is performed at an early stage. The American surgery is invasive, with more chance of infection. However, insurance won’t pay for surgery in Spain either.

In spite of this, the Ballas have scheduled the operation for Oct. 7. This means Cathleen has to fly to Spain on Oct. 6.

Cathleen has received some help from the Chiari Institute in Great Neck, NY., but a group of friends is raising funds for the surgery and ancillary expenses. The surgery will cost about $22,000, unless the dollar continues to fall against the euro.

She and her mother, Sara, have their plane fare taken care of, but Cathleen really would like her sister, Gabriella, 16, and her father, George, to come along. She would like her brother, George, 19, to come as well, but understands he can’t miss the time away from school. He is a mechanical engineering major at Rutgers.

The Ballas will also need a place to stay in Barcelona for a few days. Cathleen can’t fly home immediately after surgery because of the pressure of the plane. And, she admits, she’d like to see a little of the city while she’s there.

Family friend Clara Uhlmer has taken on Cathleen’s situation as a mission.

Taking over Knowlton Township Clerk Lisa Patton’s office one day last week, Uhlmer outlined her plans for getting Cathleen to Spain.

“We figure someone must have frequent flyer miles to donate to Gabriella to fly,” she noted. “Maybe someone even has a time-share in Barcelona they could loan the family.”

While seeking these donations, she has arranged fund raisers to help.

Next Saturday, Cathypaloosa will grace Tunnel Fields, bringing back a tradition of battles of the bands at this Route 94 venue. Cathypaloosa runs from 2 to 8 p.m. and features a dunk tank and other events as well as the bands, which include Gentleman’s Club. Knowlton Township Mayor Frank VanHorn promises the Warren County Dairy Princess and other surprises. VanHorn is known for his surprises. He also promised Cathleen a ride on his motorcycle, possibly with the Knowlton Beaver. All of this is for a $5 donation.

Another fund raiser is a Sept. 12 pig roast and bike rally, starting at Tramontin Motorcycles in Hope and ending at the Lion’s Club pavilion in Delaware Village for a pig roast. Tickets are $20 for the motorcycle driver, which include a t-shirt, and $10 for passengers. Tickets for the pig roast alone are $10 for adults, $5 for children 12 and under and free for children 3 and under. Patton is fielding calls for the roast at 908-459-4816 ext. 11. Patton said all members of the Lion’s Club and the township committee members are selling tickets.

A clothing drive is running through 3 p.m. on August 18 at 28 Hainesburg River Road in Columbia. All clothing except winter coats or sweaters and all shoes (but no skates or winter boots) will be accepted as will handbags and belts, soft luggage and backpacks and small toys and stuffed animals.

Cathy’s Cans is a soda can drive at the same location. Tony and Kathy DeMarky of Island Dragway have agreed to donate all cans from the Great Meadows drag strip to the cause.

For information on these drives, call Sara at 908-362-3001 or Annette at 908-496-9252.

Sara Balla wouldn’t ask, but friends have said she could use a car. The family has one vehicle which George needs to commute to work and Sara must take Cathleen to physical therapy, massage therapy and doctors appointments (although she maxed out on her insurance for PT).

Uhlmer said her informal group is trying to put together a tricky tray. They are receiving donations, but need a sponsoring group with a raffle license.

Meanwhile, Cathleen is spending her summer with friends and hanging out like any normal kid, until she gets too tired. “Sitting is tough,” she admitted, noting she hopes she can move around during the 8-hour airplane ride. She is looking forward to riding on the mayor’s motorcycle, too. A little nervous about the trip, she is confident she will be better after the surgery.

Her mother said Dr. Miguel B. Royo Salvador, who founded the Institut Neurologic de Barcelona, has performed 200 of these laser surgeries and 199 had the outcome he predicted. Cathleen believes she will be the 200th success.

http://www.nj.com/warrenreporter/index.ssf/2010/07/community_steps_up_to_help_kno.html

2010-07-22T12:18:00.000+01:00

Mechanisms of cerebellar tonsil herniation in patients with Chiari malformations as guide to clinical management

Acta Neurochir (2010) 152:1117–1127.DOI 10.1007/s00701-010-0636-3

The pathogenesis of Chiari malformations is incompletely understood. We tested the hypothesis that different etiologies have different mechanisms of cerebellar tonsil herniation (CTH), as revealed by posterior cranial fossa (PCF) morphology.

Methods In 741 patients with Chiari malformation type I (CM-I) and 11 patients with Chiari malformation type II (CM-II), the size of the occipital enchondrium and volume of the PCF (PCFV) were measured on reconstructed 2D-CT and MR images of the skull. Measurements were compared with those in 80 age- and sex-matched healthy control individuals, and the results were correlated with clinical findings.

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2010-07-22T01:35:00.000+01:00

REVIEW ARTICLE

Year : 2010 | Volume : 1 | Issue : 1 | Page : 58-63

Neurenteric cysts of the spine

Jesse J Savage¹, James N Casey², Ian T McNeill², Jonathan H Sherman¹
¹Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA
²University of Virginia School of Medicine, Charlottesville, VA,USA

Neurenteric cysts account for 0.7-1.3% of spinal axis tumors. These rare lesions result from the inappropriate partitioning of the embryonic notochordal plate and presumptive endoderm during the third week of human development. Heterotopic rests of epithelium reminiscent of gastrointestinal and respiratory tissue lead to eventual formation of compressive cystic lesions of the pediatric and adult spine.

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2010-07-21T23:00:00.001+01:00

From the Hospital General Universitario de Alicante, Spain, Neurosurgery blog.

Characterization of Cyclic CSF Flow in the Foramen Magnum and Upper Cervical Spinal Canal with MR Flow Imaging and Computational Fluid Dynamics

AJNR Am J Neuroradiol 31:997–1002.DOI 10.3174/ajnr.A1995

CSF flow has been shown to exhibit complex patterns in MR images in both healthy subjects and in patients with Chiari I. Abnormal CSF flow oscillations, according to prevailing opinion, cause syringomyelia and other clinical manifestations that affect some patients with the Chiari I malformation.

2010-07-21T17:17:00.000+01:00

Chronicle People - Amy overcomes the odds

Published date: 21 July 2010 | Published by: Geraint Jones

BANGOR University student Amy Fanning had more reason than most to celebrate her graduation on Thursday.

Amy,23, gained a first class degree in psychology and criminology despite taking her finals while suffering from a serious brain condition.

She was diagnosed with Chiari malformation, where the brain presses down on the spinal chord, which can cause paralysis if left untreated.

2010-07-16T17:06:00.004+01:00

What is Chiari Malformation?

Chiari (Pronounced key-ar-ee) Malformation or Arnold-Chiari Malformation is a condition in which the cerebellum portion of the brain protrudes into the spinal canal. It may or may not be apparent at birth. Arnold-Chiari I type malformation usually causes symptoms in young adults and is often associated with syringomyelia, in which a tubular cavity develops within the spinal cord. Arnold-Chiari II type malformation is associated with myelomeningocele (a defect of the spine) and hydrocephalus (increased cerebrospinal fluid and pressure within the brain), which usually are apparent at birth. Myelomeningocele usually causes paralysis of the legs and, less commonly, the arms. If left untreated, hydrocephalus can cause mental impairment. Either type of Arnold-Chiari Malformation can cause symptoms of headache, vomiting, difficulty swallowing, and hoarseness.

Adults and adolescents who are unaware they have Arnold-Chiari I type malformation may develop headache that is predominantly located in the back of the head and is increased by coughing or straining. Symptoms of progressive brain impairment may include dizziness, an impaired ability to coordinate movement, double vision, and involuntary, rapid, downward eye movements.

Is there any treatment?

Infants and children with myelomeningocele may require surgery to repair protrusion of the meningeal sac into the spinal cord. Hydrocephalus may be treated with surgical implantation of a shunt to relieve increased pressure on the brain. Some adults with Arnold-Chiari Malformation may benefit from surgery in which the existing opening in the back of the skull is enlarged.

What is the prognosis?

Infants with very severe malformations may have life-threatening complications. Most patients who have surgery experience a reduction in their symptoms. Some patients may experience prolonged periods of relative stability.

2010-07-16T17:03:00.003+01:00

Hans Chiari was born in Vienna in 1851, the son of the gynaecologist Johann Chiari (1817-1854). He studied medicine in Vienna and in 1874-1875 served as assistant to the famous Karl Freiherr von Rokitansky (1804-1878). Following graduation in Vienna he served as assistant to Richard Ladislaus Heschl (1824-1881) until 1879. In 1878 he was habilitated in pathological anatomy in Vienna, and four years later he became extraordinarius in Prague. The following year he was appointed ordinarius and superintendent of the pathological-anatomical museum in Prague. In 1906 he was appointed ordinarius of pathological anatomy in Strassburg, where he remained until his death.

During the years from 1876 to 1916 Chiari published more than 177 writings. His publications are distinguished by his exhaustive knowledge of medical literature, being extremely careful to give credit to the discoveries of others. The majority of his works concern systematic post-mortem examinations, a field to which he devoted a separate monograph. In connection with autopsies he was also careful to take care of interesting material, partly for his own teaching, partly for the museum.

In 1891 he described a brain malformation that is characterized by abnormalities in the region where the brain and spinal cord meet, and it causes part of the cerebellum to protrude through the foramen magnum (bottom of the skull) into the spinal canal. This was to be called the Arnold-Chiari malformation, named after Chiari and German pathologist, Julius Arnold (1835 − 1915). The malformation was given its name in 1907 by two of Dr. Arnold's students.

Other classifications include the Chiari Malformation Types II and III, each with more rhomboencephalic derivative involvement (i.e.- cerebellar vermis, brainstem, fourth ventricle). A common thread to all three types of malformations include the loss of normal free movement of the cerebrospinal fluid (CSF) out of the normal outlet channels of the fourth ventricle.

The pathophysiology leading to the Chiari I Malformation has not been completely elucidated to date, although several theories include: restricted posterior fossa volume compared to posterior fossa neural elements, possibly due to an underdeveloped occipital somite or to an overdeveloped suptratentorial component and shallow posterior fossa, causing cerebellar herniation; CSF flow across the foramen magnum is abnormal, leading to herniation by the mismatch of volume and pulsations of the CSF forcing open the central spinal canal; or the normal CSF flow is prevented in the compartment of the spinal cord. However, the best evidence thus far seems to support that there is a craniospinal pressure gradient across the foramen magnum that causes the brainstem herniation.

A large majority of cases of Chiari I malformations are congenital, but there are some reports of acquired malformations secondary to CSF shunts. The true incidence of CIM is unknown; however, in a report by Friede, out of 7,400 brain dissections, 2 cases of C1M as well as 46 additional examples of ‘chronic tonsillar herniation’ were reported.

Some patients may be completely asymptomatic. However, the most common presenting symptom of patients with CIM is pain. The patient may present with headache or neck pain, exacerbated by physical activity or neck movement. The pain may also be exacerbated by activities that use the Valsalva maneuver (coughing, sneezing, laughing); infants may present with irritability or grabbing at the neck. Other presentations include clumsiness, dysphagia, dysarthria, and symptom complexes caused by cord compression. Symptom complexes present based on the location of the impingement on the spinal cord (i.e.- brainstem dysfunction if impinging more cranial, sensory loss if impinging more caudal, etc.). The differential diagnosis of a Chiari I Malformation includes congenital vs. acquired CIM’s, intracranial mass lesion causing hindbrain herniation, and hydrocephalus.

Initial workup includes analysis of supratentorial structures to ensure the absence of a mass lesion or hydrocephalus. The mainstay of diagnosis of CIM is via MRI. Although hindbrain herniation 5 mm below the foramen magnum has been used as a rough ‘cut-off’ point for the diagnosis of a CIM, the extent of hindbrain herniation as well as the clinical picture of the patient should be used to diagnose CIM. Patients may be seen with herniations of 2-3 mm but still have the diagnosis of CIM due to their symptom complex. Other associated radiological anomalies may occur, including atlantooccipital assimilation, basilar invagination, and fused cervical vertebrae. Also, cine cardiac-gated MRI to assess CSF flow across the foramen magnum can he helpful.

Treatment for CIM’s is surgical as no effective nonsurgical alternative exists for symptomatic patients. There is immediate relief of symptoms and the objective decrease in the size of syrinxes following surgical intervention. There are multiple surgical techniques employed, ranging from simple decompression, osseous decompression, osseous decompression with dural grafting, osseous decompression with dural grafting and intradural dissection of adhesions, and osseous decompression with dural grafting, intradural dissection, tonsilar manipulation and dissection. The success of decompression should be confirmed with intraoperative ultrasound to assess CSF flow.

2010-07-16T16:44:00.001+01:00

In Chiari Malformation a CSF obstruction is common and can lead to a Syrinx (Syringomyelia) Formation.

Cerebrospinal Fluid (CSF)

Find out more about CSF here

Brain Anatomy

Learn how the brain works here

Spinal Cord Anatomy:

learn all about the spinal cord here

2010-07-08T02:18:00.005+01:00

Freedom of Information

The Freedom of Information Acts 1997 & 2003 give each individual legal rights to access both personal and non-personal (corporate) records, to have personal records amended or deleted where the information is incorrect or misleading and the right to seek reasons for decisions that affect him/her.

These rights extend to your own personal records and in specific circumstances, to those of your children and deceased relatives. There are exemptions provided for in the Acts, this means that there are specific circumstances when the requested information will not be released, e.g. to protect confidentiality. If any of these exemptions are used to withhold information, the reasons will be clearly explained to you.

When to use the Freedom of Information Acts:

It is recommended that applications for sensitive health records should be made under the FOI Acts (e.g. psychiatric records, and in circumstances where the records requested relate to a child or deceased person). You must apply in writing and simply refer to the Freedom of Information Acts. There is no fee when you request access to personal information.

Entitlements under the FOI Acts:

Receipt of your request must be acknowledged within 10 working days
A response will, in normal circumstances, be issued within 20 working days of receipt of the request
All decisions must be clearly explained, setting out the sections of the Act used in reaching these decisions
Details of your entitlements to Internal Review and appeal will be included in the decision letter
Why was the Freedom of Information Act Introduced?

The Freedom of Information Act was introduced to:

Increase openness
Improve accountability
Increase public appreciation of issues involved in policy decisions
Give stronger public ownership and acceptance of decisions made
Permit people access to their records and allow them to amend records if incorrect
The Act sets out three new legal rights

A legal right for each person to access information held by public bodies
A legal right to have official information relating to him/herself amended where it its incomplete, incorrect or misleading
A legal right to be given reasons for decisions affecting them
What records can accessed under FOI?

All records created after the Act commenced
All personal records of clients, whenever created
All records of staff created after 21st October 1995
Earlier records if needed to understand later records which are accessed
Under Section 7 of the Act, a person may make a request for access to records. This request must be in writing stating that the request is made under the Act and containing sufficient particulars in relation to the information concerned to enable the record to be identified.

Under Section 18 of the Act, a member of the public has the right to request information regarding acts of public bodies affecting them. A Freedom of Information request is a very formal procedure and the public body is required to respond within four weeks. The request will be considered in accordance with the Act having regard to the exemptions provided for which include:

Personal information (other than information relating to the person making the request)
Information supplied to the HSE in confidence
Law enforcement and public safety
Commercially sensitive information
Deliberations of public bodies
Functions and negotiations of public bodies
While the HSE will seek to protect the privacy of individuals and information supplied in confidence, in certain circumstances it may be in the public interest to release such information.

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