What is Chiari-like malformation (CM)

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Chiari-like malformation (CM).

Chiari-like malformation is an inherited disorder characterized by a mismatch between brain and skull volume. It is mostly commonly seen in toy breeds, in particular the Cavalier King Charles spaniel, King Charles spaniel and Griffon Bruxellois

In CM the skull is too small and the brain is too big, which leads to the brain being squashed and pushed out the back of the dog’s skull (foramen magnum) into the vertebral canal. This obstructs the flow of cerebrospinal fluid in and out of the brain. CM can be extremely painful and surgery may be an option to relieve pain and suffering and improve the flow of cerebrospinal fluid. Chiari-like malformation is a birth defect where the dog is born with the condition.

  • Signs: pain; behavioral changes; cervical scoliosis; weakness and muscle atrophy; pelvic limb weakness and ataxia.
  • Diagnosis: clinical signs; MRI.
  • Treatment: medical management; surgery (cranial – cervical decompressions).
  • Prognosis: guarded.

From Wikipedia, the free encyclopedia:

The type of treatment needed for dogs diagnosed with CM/SM depends on the severity of the condition and the age of the dog. Young dogs with clinical signs should be considered for surgical removal to minimize the progression of the disease as the dog ages. Older dogs with little or no clinical signs may be treated medically, rather than surgically. However, severe cases of CM/SM may require surgery regardless of age. The goal of surgery is syrynx decompression through restoration of normal cerebrospinal fluid circulation.[15]

Dr. Dominic Marino and Dr. Curtis Dewey (both board-certified surgeons) developed a procedure for the surgical treatment of CM in dogs, described as “foramen magnum decompression (FMD).[16] Despite an approximately 80% success rate with this surgical technique, there is a 25% to 50% relapse, primarily due to excessive scar tissue formation at the decompression site.[17] Subsequently they adapted a procedure used in people called cranioplasty, in which a plate, constructed using titanium mesh and bone cement is fixed to the back of the skull following a standard FMD procedure. The procedure had been effective in humans. The postoperative relapse rate associated with the titanium cranioplasty procedure is less than 7%.






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