Question and Answer with Dr Arnold Menezes
Professor of Neurosurgery University of Iowa Hospitals and Clinics and member of the ASAP Medical Advisory Board 

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I have a Chiari malformation with a 7mm tonsillar herniation. Does the herniation become greater over time?

The diagnosis of Chiari Malformation on magnetic resonance imaging is not only with a tonsillar herniation of 4-5 mm into the cervical canal but also with other associated findings. The literature shows that the tonsillar herniation may regress or otherwise. There are many other factors such as the timing of the MRI as well as the presence of hydrocephalus.

In patients with Syringomyelia are new symptoms always a sign that the syrinx has progressed?

The patient is always made aware of occurrence of new symptoms so as to alert the health care personnel to the possibility of either progression of the radiographic abnormality or some other simultaneously occurring phenomenon. Thus, it is very important to pay attention to the development of new symptoms in patients with Chiari Malformation and Syringomyelia.