Smart, pretty, and successful Erin Brennan was 23 years old when she began to suffer dizzy spells after her kickboxing classes. At first the dizziness would pass fairly quickly, but soon these episodes became more frequent and more debilitating. Eventually they were accompanied by nausea and fatigue. A registered nurse, Erin was finding it difficult to be on her feet all day tending to patients while she herself felt so poorly. She made an appointment to see her doctor and he immediately signed her up for an MRI of her brain. Chiari malformation was the diagnosis. Luckily, Erin was fortunate enough to find Dr. Thomas Milhorat, Chairman of the Departments of Neurosurgery at Long Island Jewish Medical Center and North Shore University Hospital. He evaluated her case and discussed the option of surgery with her. The decision for or against surgery would have to be carefully weighed by Erin. Dr. Milhorat asked her to evaluate her life and decide how badly it was being affected by the malformation. Since by this time she was having trouble swallowing, Erin knew that she would have to go ahead with surgery, daunting as this prospect seemed. Her doctors warned her that despite all the fancy diagnostic tools that were available—MRI, radiography, CT—they would not truly know how severe the malformation was until they were actually in surgery. During the surgery they discovered that the condition was more extensive than they had previously thought.
Despite the seriousness of her condition, the surgery went smoothly and Erin’s post-operative recovery went off without a hitch. All of her symptoms were gone. Today, seven years later, she has been warned to stay away from roller coasters and not to lift more than 30 pounds, but otherwise her life is like anyone else’s—and she is an avid snowboarder.
This would be the end of this little vignette except that it so happens that Erin adopted a little Chihuahua puppy shortly after her surgery. She named her new puppy Lucy. When Lucy was 5 years old, she began to show some strange neurologic signs, most notably a “dropped jaw,” or an inability to properly close the mouth. Erin brought Lucy to see the neurosurgeons at Long Island Veterinary Specialists and Lucy was promptly admitted to the hospital for an MRI of her brain. Dr. Marino, chief of staff and Chairman of the Canine Chiari Institute at LIVS reviewed the images of Lucy’s brain and immediately knew what Lucy’s problem was. His concern was how to explain to Erin the implications of Lucy’s complicated syndrome. As he began to gently explain the results of the MRI Erin actually laughed out loud. Dr. Marino had just informed her that Lucy was suffering from Chiari malformation! Referred to as Chiari Like Malformation in veterinary medicine, corrective surgery was recommended for Lucy to relieve the pressure on her brain and spinal cord. In addition to the malformation, Lucy also had a cyst present within her brain that would have to be addressed. The decision to proceed with surgery wasn’t a difficult one for Erin as she knew exactly what to expect and what Lucy would be going through. There were 2 parts to Lucy’s surgery, the decompression surgery (similar to the surgery Erin had undergone), and the placement of a tube (or “shunt”) that drained the fluid from the cyst in her brain and carried it to the abdomen where the extra fluid would cause no problems. Lucy took some time to convalesce, but 18 months after surgery she is a perky puppy with no signs of her previous difficulties. Erin humbly offers these wise words regarding her story, “The doctors we have dealt with are at the forefront of their fields. People come from all over the world to see these doctors. I just can’t believe how lucky we were that they were in my backyard and so accessible to Lucy and me.”