The Chiari Institute is a medical institution that focuses on the treatment of
Arnold–Chiari malformation
Chiari malformation (CM) is a structural defect in the cerebellum, characterized by a downward displacement of one or both cerebellar tonsils through the foramen magnum (the opening at the base of the skull). CMs can cause headaches, difficulty ...
and
syringomyelia
Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. Often, syringomyelia is used as a generic term before an etiology is determined. This cyst, called a syrinx, can expand and elongate ...
. It was established in 2001 by the
North Shore-LIJ Health System
Northwell Health is a nonprofit integrated healthcare network that is New York State's largest healthcare provider and private employer, with more than 81,000 employees.
The flagship hospitals of Northwell are North Shore University Hosp ...
, and is located in
Great Neck, New York
Great Neck is a region on Long Island, New York, that covers a peninsula on the North Shore (Long Island), North Shore and includes nine villages, among them Great Neck (village), New York, Great Neck, Great Neck Estates, New York, Great Neck Es ...
. The institute was founded by Thomas H. Milhorat, MD shortly after he was appointed the Chairman of
Neurosurgery
Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peri ...
Daily News (New York)
The New York ''Daily News'', officially titled the ''Daily News'', is an American newspaper based in Jersey City, NJ. It was founded in 1919 by Joseph Medill Patterson as the ''Illustrated Daily News''. It was the first U.S. daily printed in ta ...
", 2009-06-18 Paolo Bolognese left TCI on September, 1st, 2014
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 (formerly known as Manhasset Hospital) is a part of Northwell Health, New York State's largest healthcare provider and private employer. It is a primary teaching hospital for the Donald & Barbara Zucker School of ...
. 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. They also published the first description of a decompression surgery utilizing color
Doppler sonography
Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to perform imaging of the movement of tissues and body fluids (usually blood), and their relative velocity to the probe. By calculating the frequency shift of ...
. 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 is one of the four primary types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tiss ...
. 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 a paper saying that syncope is a potential symptom of
Eagle syndrome
Eagle syndrome (also termed stylohyoid syndrome, styloid syndrome, styloid-stylohyoid syndrome, or styloid–carotid artery syndrome) is a rare condition commonly characterized but not limited to sudden, sharp nerve-like pain in the jaw bone and j ...
, a condition in which the temporal bone of the skull is elongated and conflicts with other anatomy.
Lawsuits
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.Evans, Heidi "Independent investigation starts on 2 North Shore no-show brain doctors" "Daily News (New York)", 2009-06-10 Both doctors were suspended by the North Shore University Hospital, though Bolognese has been reinstated. Milhorat resigned from his position.Evans, Heidi "Daily News (New York)", 2009-05-14
The media has reported on various pending lawsuits, including a
class-action lawsuit
A class action, also known as a class-action lawsuit, class suit, or representative action, is a type of lawsuit where one of the parties is a group of people who are represented collectively by a member or members of that group. The class action ...
NBC News
NBC News is the news division of the American broadcast television network NBC. The division operates under NBCUniversal Television and Streaming, a division of NBCUniversal, which is, in turn, a subsidiary of Comcast. The news division's var ...
", 2009-05-19"Embattled NY surgeons sued" "
United Press International
United Press International (UPI) is an American international news agency whose newswires, photo, news film, and audio services provided news material to thousands of newspapers, magazines, radio and television stations for most of the 20th ...
tethered spinal cord syndrome
Tethered cord syndrome (TCS) refers to a group of neurological disorders that relate to malformations of the spinal cord.Evans, Heidi "Family sues North Shore University Hospital, neurosurgeons for 'experimenting' on kid" "Daily News (New York)", 2009-05-11Evans, Heidi "Daily News (New York)", 2009-05-19 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
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
(NIH) or the
Institutional Review Board
An institutional review board (IRB), also known as an independent ethics committee (IEC), ethical review board (ERB), or research ethics board (REB), is a committee that applies research ethics by reviewing the methods proposed for research to ens ...
(IRB).
None of these suits have been resolved, and no trial dates are known.