Twelve-year-old boy with chronic headaches gets a new lease of life at Medcare Orthopaedics and Spine Hospital

• Chiari malformation is a growth abnormality where brain tissue in the lower back of the skull extends into the spinal canal
• Dr. Gopalakrishnan C.V., Consultant Neurosurgeon atMedcare Orthopaedics & Spine Hospital performed a decompression surgery to address this abnormality in the child’sbrain   that caused persistent headaches.
• Early detection of this condition in the patient, which generally eludes discovery until adulthood, enabled intervention to improve long-term quality of life.

Dubai, June21, 2024:A 12-year-old boy with a congenital condition called Chiari malformationhas been blessed with a newfound lease of life after undergoing a decompression surgery at Medcare Orthopaedics & Spine Hospital (MOSH)in Dubai. The boy faced chronic headaches with balance issues, which occurred due to a downward projection of the posterior part of the brain into the spinal canal.  This condition called Chiari malformation is quite uncommon among children.

According to Dr. Gopalakrishnan C.V, Consultant Neuro and Spine Surgery at MOSH, who treated the young patient, the issue often goesundetected until adulthood, highlighting the significance of how early diagnosis and prompt treatment can open the door for a better future. He said, “This case marks a significant milestone in paediatric healthcare as early detection of the malformation during childhood is rare.”

Speaking about the initial presentation of symptoms in the patient, Dr. Gopalakrishnan said, “The young boysuffered from a series of distressing symptoms, initially misattributed to a viral infection. What began as minor ailments like frequent incessant headaches, fever, and dizziness gradually escalated, culminating in sudden gait ataxia, a type of muscle control losscharacterised by limited ability or inability to coordinate normal walking movements.”

“Despite the initial diagnostic challenge, intermittent occipital headachesand neck pain persisted. This was compounded by occasional episodes of headache and nausea over a period of two years, raising suspicion of an underlying condition that required specialised attention. Consequently, the patient was referred to MOSH for evaluation and management,” he added.

Commenting on the findings upon the patient’s arrival at MOSH, Dr. Gopalakrishnan said, “The MRI scans revealed elongated cerebellar tonsils, part of the brain responsible for coordinating the voluntary movement of distal parts of the limbs, extending below the opening in the base of the skull that connects the spinal cord to the brain. This structural anomaly was exerting pressure on the brain, disrupting the normal flow of cerebrospinal fluid and contributing to the onset of the child’s symptoms.”

“Our team swiftly devised a tailored treatment plan using decompression surgery to address the underlying pathology and alleviate the patient’s distressing symptoms. This procedure involved removing pieces of bone from the base of the skull and the top of the spine to relieve the compression. By addressing the root cause of the patient’s symptoms, we aimed to improve his overall quality of life and restore his health and well-being,” he elaborated.

Under general anaesthesia, the surgery involved a careful incision at the back of the patient’s head to access the base of the skull. A small portion of the bone was delicately removed, covering of the brain was opened to excise any tight bands and a layer of scalp tissue was used as a patch to increase the volume and relieve the compression on the brain. Additionally, a section of the bone from the top of the spine was also removedto further facilitate the normalization of cerebrospinal fluid flow.

Discussing the patient’s recovery, Dr. Gopalakrishnan said, “The patient has shown remarkable progress and his symptoms have significantly improved. While his condition will continue to be closely monitored, we are optimistic about his long-term prognosis and expect him to lead a fulfilling and healthy life moving forward.”

Regarding the exceptional nature of the early diagnosis of Chiari malformation during childhood, Dr. Gopalakrishnan remarked, “This condition, although present in childhood, usually remains undiscovered until the patient reaches adulthoodwhen symptoms develop or when an MRI scan is done.The exact cause of Chiari malformations is unknown. Many cases are thought to be the result of part of the skull not being large enough to accommodate the back of the brain.Chiari malformations can also develop in people with a tethered spinal cord, a build-up of fluid in the brain (hydrocephalus), and some types of brain tumour.The unique circumstances of this case that led to early detection allowed for timely intervention, offering our young patient a chance at a better quality of life.”

About 1 in 1000 people have symptoms associated with Chiari malformation, althougharound 1 in 100 meetthe diagnostic criteria, making it a commonneurological condition. Although the exact cause of Chiari malformations remains elusive, Dr. Gopalakrishnan feels optimistic about future treatment management strategies. According to him, proactive paediatric medical evaluation offers hope for improved long-term outcomes for patients.

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About Medcare:

Medcare is the premium private healthcare provider under the parent group, Aster DM Healthcare. Operating leading state-of-the-art Hospitals, including Medcare Multi-specialty Hospital in Dubai and Sharjah, Medcare Women & Children Hospital, Medcare Orthopaedics and Spine Hospital, and 20 medical centres in the UAE, Medcare has established a strong presence in the UAE.