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Ahmed (name changed to protect privacy), 12, frequently missed school or went home early due to severe headaches. Along with neck pain and dizziness, he battled chronic aches for nearly two years before a fever helped accurately diagnose his condition. He has now got a new lease of life after undergoing surgery at a Dubai hospital.
“He used to complain of headaches and neck pain, especially on the back side of the neck. When the patient came to me for consultation, the headaches had worsened, and he was developing balance issues. Initially it was thought that this was due to a fever that he had but on detailed evaluation and after an MRI scan of the brain, it was diagnosed that he had a chiari malformation,” Dr Gopalakrishnan CV, consultant neurosurgery & spine surgery, Medcare Orthopaedics and Spine Hospital, told Khaleej Times.
This malformation is a growth abnormality where brain tissue in the lower back of the skull extends into the spinal canal.
With reduced attention span, the 12-year-old was unable to concentrate in school. “The young boy suffered 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 loss characterised by limited ability or inability to coordinate normal walking movements.”
He underwent a decompression surgery, which involved removing pieces of bone from the base of the skull and the top of the spine to relieve the compression.
“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,” said the doctor.
After the surgery, the boy’s condition has significantly improved. “His headaches have come down both in frequency and as well as in intensity,” said Dr Gopalakrishnan.
Had his condition not been detected, Ahmed would have found it difficult to play sports or undertake any physical activities. Even walking would have become difficult, with a tendency to fall.
The expert advised parents to not dismiss their children’s headaches as excuses to miss school.
Chiari malformation often goes undetected until adulthood. “This condition, although present in childhood, usually remains undiscovered … 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.
“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."
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