<s>[INST] I have just been diagnosed with Chiari malformation. However I am reading that this is something that happens at birth. I am a 55 year old woman. Why would symptoms appear now? I am having headaches regularly thus the MRI on my head. What course of action is there? I have not met with a neurosurgeon yet. [/INST] Hi,Thank you for posting your query.I have noted your MRI brain findings as well as the symptoms.You are spot on in doubting that why would Chiari malformation cause symptoms at the age of 55, even though it occurs at birth.I agree with you that Chiari malformation is an incidental finding in your case, and your headaches are unrelated to that. Therefore, Chiari malformation can be left alone and no surgery is needed.At the same time, we need to find out the cause of headache in your case, and treat that.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG: </s>