Deep in the human skull

    There are two main issues we must talk about. These are called Basilar Invagination (BI)

    and Chiari I Malformation (CM). It is important to know that these can cause big health problems.

    BI means that the bottom of the skull sticks into the top part of the spinal cord.

    CM is when part of the brain moves down through the opening at the base of the skull

    into the spinal canal.  Most of the time these do not happen together. .

     . It is great  if they are caught early. But when untreated they will cause big issues.    That’s why  some experts got together. They wanted to know more about these issues and how to best deal with them.

     Basing their work on a systematic review of previous research,

     they took help from the Delphi method.

    This method is when experts answer questions

     and then, based on everyone’s answers,

    they figure out what they think is best.  they want to provide helpful tips and guidelines

     for doctors and other health professionals.

      This gathering of information  can be a tough task.  Often, doctors and researchers

      might not spot the problems when reading  medical images.

      Be it X-rays

      or CT scans. A single mistake in interpreting these images.   So it is important to catch the problem with accuracy.

     . Later on,  treatment is very complicated

     . There are lots of things to think about.   Such as, CAN surgery happen? Should we operate? What if it goes wrong?  For beginners. DO WE NEED TO OPERATE AT ALL?

      The objective of the team then became mainly to bring out

      the clearest answers to these questions and to give the best advice.

      Think of it like this.   Take 100 people with the same issue.

       Its important to know that each person is quite different

       from the next. Many things will have to be considered.

      For instance can they walk or move? Can the person move their arms or legs?

             . And also the age of the person

       With these points the doctors will be able

       to give advice on whether or not to operate

      So its crucial for doctors to make informed decisions. Decisions that can lead to milestones

       in the proper management of the issues

       But remember if doctors are too forceful with surgery  It could cause more trouble.

       So its really important to balance things out here.

        The problems faced by doctors also varies. . In some cases, a small gap in a bone of neck could be the culprit

         In other places it might be something more complicated and some of these may need surgery too.

       see. such issues can cause people to not be able to move around or control their limbs.

       Treatment generally involves surgery. But is the surgery always successful?

       This is a huge question mark.

       .  As doctors, you rely on them to suggest treatments. And they too rely on evidence.

       Bad evidence can lead to problems.

       Of course researchers want to give out good evidence. But the data might not always show results.

      So be aware.

      There are methods, however, that can make surgery safer. This includes fixing the bone of the neck

       that was causing trouble in the first place.

       Another is called a VCR.

     This can help to expand or tighten the bottom part of the skull.

    It’s also important to remember

       that these surgeries can also cause problems.

       . So, we do not know if it is always good to operate or not.

        .

     The other method, which seems more popular is to bypass surgery altogether and opt for

      something called "non-invasive. "  This means using medicine

      and other ways to treat the problem without surgery.

      . Even here though, we have to be careful. They have to put in a lot of thought before choosing this path.

      . Some patients may not be allowed the surgical treatment. But what if other treatments

      also don't work for them?

      .

     There are other things to think about too.

      Biological information seems to play a huge role.

       With this you can predict who can get help

      and who can't even though the problems seem similar

      Another big problem is the lack of researches and studies. So we cannot be certain about everything.

      We don't have enough information

      . There are hopes for the future. With doctors and researchers working on it

       there will be advances and breakthroughs. We are very hopeful.

      What we know so far is that these problems can be solved if you look at the situation carefully.  But we need a careful approach.

Untangling The Basilar Invagination and Chiari I Malformation Challenge

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