The Chiari Institute
Encyclopedia
The Chiari Institute is a medical institution that focuses on the treatment of Arnold-Chiari malformation
and syringomyelia
. It was established in 2001 by the North Shore-LIJ Health System
, and is located in Great Neck, New York
. The Institute was founded by Thomas H. Milhorat, MD shortly after he was appointed the Chairman of Neurosurgery
at the North Shore-Long Island Jewish Health System. It is now led by Raj Narayan, MD and Paolo Bolognese, MD. Dr. Bolognese has no Board Certification in any medical specialty.
The institute itself is used as a treatment facility for patients with Chiari malformations and related illnesses. Research projects are carried out at the Boas-Marks Research Center, located on the campus of North Shore University Hospital
. While working with the Chiari Institute, Milhorat and Bolognese have published several articles related to the diagnosis and treatment of Chiari malformations.
In 2003 a case report was published stating that, contrary to previously held belief, syringomyelia can present with a rapid progression of acute symptoms and requires the immediate placing of a ventriculoperitoneal shunt
. They also published the first description of a decompression surgery utilizing color Doppler sonography. This technique has been used by Bolognese since 1999, and at the time the article was published had been used in more than 300 surgeries. This technique is meant to improve surgical technique and monitor patient-specific variables.
In 2007 they established an association between type one Chiari malformations and hereditary disorders of connective tissue
. Both conditions can cause hypermobility of the neck and cranial settling. While the conditions are often treated differently, the findings showed that 12.7% of patients with type one Chiari malformations also presented with hereditary disorders of connective tissue and/or Ehlers-Danlos syndrome
.
More recently, the doctors from the Chiari Institute published proof that syncope
is a potential symptom of Eagle syndrome
, a condition where the temporal bone of the skull is elongated and conflicts with other anatomy.
The media has reported on various pending lawsuits, including a class action law suit headed by the firms Lockslaw and Goldsmith, Ctorides & Rodriguez. According to these lawsuits, patients were purposefully misdiagnosed and told that the procedure used for tethered spinal cord syndrome
would alleviate the symptoms of their chiari malformations. This method of treating chiari malformations is untested and unproven in the scientific community, which would classify it as experimental. The lawsuits allege that informed consent was not acquired before these experimental procedures and that none of the required funding or approvals can be found for any such research with either the National Institutes of Health
(NIH) or the Institutional Review Board
(IRB).
None of these suits have been resolved, and no trial dates are known.
Arnold-Chiari malformation
Arnold–Chiari malformation, or often simply Chiari malformation, is a malformation of the brain. It consists of a downward displacement of the cerebellar tonsils through the foramen magnum , sometimes causing non-communicating hydrocephalus as a result of obstruction of cerebrospinal fluid outflow...
and syringomyelia
Syringomyelia
Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in pain, paralysis, weakness, and stiffness in the back, shoulders, and...
. It was established in 2001 by the North Shore-LIJ Health System
North Shore-LIJ Health System
The North Shore-Long Island Jewish Health System was founded in 1997 with the merger of the North Shore Health System and LIJ Medical Center, creating a healthcare network that now includes 15 hospitals , The Feinstein Institute for Medical Research, rehabilitation and skilled nursing facilities, ...
, and is located in Great Neck, New York
Great Neck, New York
The term Great Neck is commonly applied to a peninsula on the North Shore of Long Island, which includes the village of Great Neck, the village of Great Neck Estates, the village of Great Neck Plaza, and others, as well as an area south of the peninsula near Lake Success and the border of Queens...
. The Institute was founded by Thomas H. Milhorat, MD shortly after he was appointed the Chairman of Neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
at the North Shore-Long Island Jewish Health System. It is now led by Raj Narayan, MD and Paolo Bolognese, MD. Dr. Bolognese has no Board Certification in any medical specialty.
The institute itself is used as a treatment facility for patients with Chiari malformations and related illnesses. Research projects are carried out at the Boas-Marks Research Center, located on the campus of North Shore University Hospital
North Shore University Hospital
North Shore University Hospital is one of the cornerstones of the North Shore-LIJ Health System, as well as an academic campus for the New York University School of Medicine and the Albert Einstein College of Medicine....
. While working with the Chiari Institute, Milhorat and Bolognese have published several articles related to the diagnosis and treatment of Chiari malformations.
Research
The Chiari Institute has been listed as a contributing facility to a number of published medical findings and reports. Most, if not all, have involved the work of Thomas Milhorat and Paolo Bolognese.In 2003 a case report was published stating that, contrary to previously held belief, syringomyelia can present with a rapid progression of acute symptoms and requires the immediate placing of a ventriculoperitoneal shunt
Shunt (medical)
In medicine, a shunt is a hole or a small passage which moves, or allows movement of fluid from one part of the body to another. The term may describe either congenital or acquired shunts; and acquired shunts may be either biological or mechanical.* Cardiac shunts may be described as...
. They also published the first description of a decompression surgery utilizing color Doppler sonography. This technique has been used by Bolognese since 1999, and at the time the article was published had been used in more than 300 surgeries. This technique is meant to improve surgical technique and monitor patient-specific variables.
In 2007 they established an association between type one Chiari malformations and hereditary disorders of connective tissue
Connective tissue
"Connective tissue" is a fibrous tissue. It is one of the four traditional classes of tissues . Connective Tissue is found throughout the body.In fact the whole framework of the skeleton and the different specialized connective tissues from the crown of the head to the toes determine the form of...
. Both conditions can cause hypermobility of the neck and cranial settling. While the conditions are often treated differently, the findings showed that 12.7% of patients with type one Chiari malformations also presented with hereditary disorders of connective tissue and/or Ehlers-Danlos syndrome
Ehlers-Danlos syndrome
Ehlers–Danlos syndrome is a group of inherited connective tissue disorders, caused by a defect in the synthesis of collagen . The collagen in connective tissue helps tissues to resist deformation...
.
More recently, the doctors from the Chiari Institute published proof that syncope
Syncope (medicine)
Syncope , the medical term for fainting, is precisely defined as a transient loss of consciousness and postural tone characterized by rapid onset, short duration, and spontaneous recovery due to global cerebral hypoperfusion that most often results from hypotension.Many forms of syncope are...
is a potential symptom of Eagle syndrome
Eagle syndrome
Eagle syndrome is a rare condition where an elongated temporal styloid process is in conflict with the adjacent anatomical structures.Two forms of eagle syndrome exists: The classic form and the vascular one.-Symptoms:...
, a condition where the temporal bone of the skull is elongated and conflicts with other anatomy.
Controversy
The Chiari Institute has a reputation for helping MANY patients who have suffered from Chiari Malformation. The Chiari Institute does not operate needlessly on patients as shown in a study of the ethics of the Chiari Institute from a neutral source. The Biased opinions are shown on this page from those who would seek to benefit from a frivolous lawsuit. There are no entries shown quoting their successes, thereby further showing the bias towards The Chiari Institute and its life saving procedures. The first lawsuit against the Institute to receive media attention was that of Jennifer Ronca who, on April 10, 2009, was anesthetized and prepared for a brain surgery that did not happen. Bolognese, her scheduled surgeon, was in Florida at the time of the surgery and Milhorat, the surgeon on call who had previously operated on Ronca, refused to perform the operation in his stead. Ronca was falsely told that Bolognese had a family emergency and her surgery was rescheduled for three weeks later. Both doctors were suspended by the North Shore University Hospital, though Bolognese has already been reinstated. Milhorat resigned from his position after the Daily News (New York) reported on the incident.The media has reported on various pending lawsuits, including a class action law suit headed by the firms Lockslaw and Goldsmith, Ctorides & Rodriguez. According to these lawsuits, patients were purposefully misdiagnosed and told that the procedure used for tethered spinal cord syndrome
Tethered spinal cord syndrome
Tethered spinal cord syndrome or occult spinal dysraphism sequence refers to a group of neurological disorders related to malformations of the spinal cord. The various forms include: tight filum terminale, lipomeningomyelocele, split cord malformations, dermal sinus tracts, dermoids, and cystoceles...
would alleviate the symptoms of their chiari malformations. This method of treating chiari malformations is untested and unproven in the scientific community, which would classify it as experimental. The lawsuits allege that informed consent was not acquired before these experimental procedures and that none of the required funding or approvals can be found for any such research with either the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
(NIH) or the Institutional Review Board
Institutional review board
An institutional review board , also known as an independent ethics committee or ethical review board , is a committee that has been formally designated to approve, monitor, and review biomedical and behavioral research involving humans with the aim to protect the rights and welfare of the...
(IRB).
None of these suits have been resolved, and no trial dates are known.