Conversation: The conversation between human and AI assistant.
[|Human|] Hi I had decompression of my Arnold chiari, in Dec 2013. Post op mri showed a pseudomenigocele. In March this year I started having the headaches again and numbness in hands and at times when headaches are bad I get pupillary changes, my right pupil is a size or 2 above the left. I had another mi which showed no change and my N S said if the symptoms are un manageable he would do a shunt as last resort.For the last 5 weeks I ve had vertigo and nausea, the dizziness occurs and goes quickly but is only over the right side. Nausea is constant heightened by turning my neck sideways. I m in constant pain and its worse of a night. It s at the site of my scar and is very deep seated. Also I feel foggy and forgetful and my concentration is awful. Friends and family although their kind their running out of sympathy.
[|AI|]  Hello user.First u need to know that Arnold Chiara is a malformation for which permanent solution is still to be obtained. Firstly, although posterior decompression is the most favored therapy it is not helpful in all the patients.’m sure your doctor has given u the right treatment because I cannot comment without seeing the patient and the images. Secondly pseudomeningocele is one of the complications of such a surgery. One more complication is cerebellar slump, which is due to cerebellar herniation through the defect and compressing on the right side of brain stem causing right cranial nerve palsies. All your right side symptoms could be attributed to them. Again its just one of the possible reasons. In my opinion u need a re exploration surgery with duroplasty. Hope I have answered your question.