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 The Chiari Institute is the world's first comprehensive, multidisciplinary center for the management of patients suffering from Chiari malformation (CM), a rare structural condition that affects the cerebellum; syringomyelia, a chronic disease of the spinal cord; and related disorders. Established in 2001 by the North Shore-Long Island Jewish Health System, the Chiari Institute has recently expanded its programs and relocated to a new state-of-the-art facility in Great Neck, N.Y.
The Chiari Institute was founded by Dr. Thomas H. Milhorat, Chairman of the Departments of Neurosurgery at North Shore University Hospital in Manhasset, N.Y., and Long Island Jewish Medical Center in New Hyde Park, N.Y., and represents the fruition of his decade-long effort to establish an institution dedicated to the treatment of these often misdiagnosed conditions.
 The institute is named in honor of Professor Hans Chiari, an Austrian pathologist who first described abnormalities of the brain at the junction of the skull and spine more than a century ago. Physician members of the Chiari Institute include neurosurgeons, neurologists and neuroradiologists, as well as specialists in pain management, cardiology, respiratory physiology, neuro-opthalmology, neuro-otology, general medicine and pediatrics.
Why develop the Chiari Institute?
The diagnosis and treatment of CM and related disorders has yet to be standardized. Controversies have arisen in the medical community regarding the diversity and variability of presenting symptoms, as well as the specific radiological criteria for diagnosis. Patients with CM1, for example, frequently experience chronic fatigue or fibromyalgia-like symptoms, yet only a small percentage of patients with these symptoms actually have CM1. On the other hand, a significant number of patients with radiographically confirmed CM1 are misdiagnosed for years as suffering from conditions such as multiple sclerosis, migraine and psychiatric disorders. A multidisciplinary team of physicians with special expertise in the diagnosis and treatment of CM is required to resolve such issues.
The need for the Chiari Institute has been patient-driven. Since 1991, Dr. Milhorat and his team have amassed the largest experience of any surgical group in the world. In 2003 alone, the team performed 292 surgical procedures at North Shore University Hospital, more than half of which were referred for re-operation because of failed Chiari surgery elsewhere. We are on a pace to do 360 cases this year. Approximately 90 percent of the institute’s patients come from outside the New York metropolitan area and represent all 50 states as well as 19 foreign countries.
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