The board-certified neurosurgical team with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, is led by Thomas M. Moriarty, M.D., Ph.D., a recognized leader in the field with extensive experience and specialized training. Our physicians have the sophisticated tools and skills to give you and your child a precise diagnosis and a treatment plan for Chiari malformation that minimizes risk, so your child can get back to being a kid again.

What Is Chiari Malformation?

Chiari malformation is a defect in the back of the head where the brain and spinal cord meet.

There are four types of Chiari malformation. Type I is the most common and the least severe. Many people have no symptoms until late adolescence or into adulthood. Often, an unexpected diagnosis is made after a person seeks medical attention for an unrelated issue.

The second most common form of Chiari malformation is type II. It is directly associated with spina bifida. It also can be associated with hydrocephalus and scoliosis. Surgery typically is needed to correct the abnormality.

Types III and IV are very serious and rare conditions that often result in severe disabilities or death.

Chiari Malformation Treatment

If Chiari malformation is not causing any symptoms, then no treatment is necessary. However, when symptoms are present, surgery typically is the only option. During surgery for Type II, small portions of the skull and neck are removed. Additional steps may be taken, depending on the specific needs of the child.

The neurosurgery team has cared for children with all types of Chiari malformations and is prepared to explain the options for your child’s condition.

Why Norton Children’s Neuroscience Institute?

• The Norton Children’s Hospital Comprehensive Epilepsy Center is a Level 4 epilepsy center, the highest rating available from the National Association of Epilepsy Centers. Norton Children’s Hospital has held this designation since 2013.
• We are the first in Kentucky and among the first in the nation to use neurostimulation in a pediatric patient.
• Regional neurology care is available for children across Kentucky and Southern Indiana. We travel to clinics in Bowling Green, Campbellsville, Corbin, Elizabethtown, Frankfort, Owensboro and Paducah, Kentucky; and Evansville, Indiana. We also perform a number of telemedicine visits each week.
• The specialists with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, use state-of-the-art technology to treat epilepsy, uncontrollable seizures and deep brain tumors in children who, in the past, would not be candidates for surgery, including:
  • Visualase: Technology that allows neurosurgeons to perform MRI-guided laser ablation surgery. Fewer than two dozen pediatric hospitals in the U.S. offer this technology.
  • Surgical Theater: Virtual reality technology that creates an immersive 3D view of a patient’s brain, allowing neurosurgeons, the patient and family to see inside the skull and brain to get a greater understanding of the condition and impact of potential procedures. Norton Children’s Hospital is the first hospital in the region to use this technology.
• We offer dedicated multidisciplinary clinics for brain tumors, traumatic brain injuries, spina bifida, craniofacial injuries and disorders, epilepsy, muscular dystrophy, spasticity, headache/migraine, autism and neurocutaneous disorders.
• Our multidisciplinary craniofacial program was the first established in the Midwest.
• We offer a neurogenetics clinic to evaluate and treat children with neurogenetic syndromes.
• We have a neuropsychology program that specializes in the evaluation of children and teens with a variety of neurological, neurodevelopmental and medical conditions, including brain tumors and epilepsy.
• Outpatient neurology facilities in downtown Louisville are equipped with in-office electroencephalography (EEG) capabilities and laboratory services in the same building, creating a streamlined, family-centered environment.
• We offer the region’s first clinic to treat children with immune-mediated neurological disorders.