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Dr. I am a 51 year old male. I am very athletic and in good physical condition. About a year ago, my blood pressure spiked to around 200/100 and I’ve been trying to regulate it ever since with medicine. Since that time, I was diagnosed with a Chiari Malformation and Syrinx. I am starting to have symptoms like blurred vision, tremors, numbness in my left arm and left foot, terrible pain at the base of my skull and a “fullness” in my head. Two questions – is there any way this blood pressure issue could be related to the Chiari? And, in your opinion (given the symptoms I’ve described), would I be a good candidate for decompression surgery. Thanks in advance.
A syrinx is a cavity in the central canal of the cord. It can be connected to the fourth ventricle or not connected. If it is connected, it is called a communicating syrinx. If not, it is a non-communicating syrinx. Syrinxes are the equivalent of enlarged ventricles in the cord and consequently sometimes referred to as hydromyelia similar to hydrocephalus in the brain. The causes are unknown. My theory is the same as in the cranial vault. It has to do with obsruction to CSF flow. The obstruction can occur in craniocervical junction or it can be caused by spondylosis and stenosis in the lower cervical spine. Spondylosis and stenosis can also cause chronic ischemia and hyperintensity signals in the cord nearby.
I am currently consulting with a much more complicated case of Chiari, anomolous dural sinus driange system, bilateral faulty IJ valves, hemangioma of the fifth thoracic vertebra, tethered cord, kyphosis, scoliosis etc. That's the short list. Researchers are just starting to catch on. The best and most recent studies have been done supine. Everything will need to be redone in the upright position. There is a long way to go yet.