Sean Murphy

After surgery for a Chiari malformation, Sean Murphy is back to skiing and his other normal pastimes.

Sean Murphy's dream vacation was seven months off when chronic headaches set in, first bothering him after physical exertion, then after a stressful day at work.

Within months, the headaches were constant, always localized in the back of his head, and the pain became debilitating.

The Rosemount, Minn., father of three consulted his family doctor about the headaches and was referred to a neurologist. His hometown physicians were stumped, leaving pain relievers as Sean's only relief.

Sean was referred to Mayo Clinic in Rochester. Sean and his wife, Natasha, hoped for an answer before a family trip to Mexico, planned for later that year.

Mayo physicians tested Sean and took a comprehensive physical history, concluding he had Chiari type I malformation, a condition in which the cerebellum portion of the brain protrudes into the spinal canal. The disorder causes a variety of neurological symptoms, but is treatable.

Meanwhile, Sean's health worsened. Always an active person, he struggled with vertigo, had difficulty swallowing and felt tingles in his shoulders.

"It was getting to the point where just doing my daily routine was an issue," recalls Sean, a senior systems administrator for MLT Vacations. "Not only was I in pain, but I'd been on narcotic pain killers for six weeks with no end in sight. I didn't want to be on pain killers for the rest of my life."

Mayo Clinic physicians initially sought to relieve Sean's symptoms with medication, but soon decided surgery was his best option. Some Chiari type I sufferers benefit most from the surgery, in which the existing opening of the back of the skull is enlarged to allow the patient's brain space to function.

Chiari type I is rare and generally presents itself during a patient's late adolescent or early adult years. Symptoms can include headaches in the back of the head, ringing in the ears, numb or dysfunctional hands, loss of pain and temperature in arms and legs and poor balance.

John Atkinson, M.D., Sean's neurosurgeon at Mayo Clinic, says the clinic sees only 15 to 20 cases of Chiari type I malformation each year. Mayo uses a comprehensive approach to treating the disorder, with specialists in neurology, neurosurgery and radiology teaming together to diagnose and treat patients.

Some patients, such as Sean, aren't responsive to medications, leaving surgery as their only course of treatment. Typically, patients recover fully within a month to six weeks and the operation is generally very successful lifelong for this condition, Atkinson says.

Sean's September 2004 surgery landed him in the hospital for four days and, within six weeks, he felt normal for the first time since the spring.

"I was snorkeling in Cancun the first of November," he says. "That's what I'd been hoping for, but it was still awesome."

Sean, 34, was also back to his normal pastimes, such as jumping on the family's trampoline with his kids, ages 3 to 11, sailing, golfing and skiing, which he'd put on hold when his headaches were at their worst.

He credits Mayo Clinic with providing superior and speedy care.

"Mayo was phenomenal," Sean says. "The whole staff was outstanding and everyone was easy to work with. It's a fairy tale how smoothly it all went."