Management of Chiari malformations: opinions from different centers—a review

David S. Hersh, Mari Groves, Frederick A. Boop

Research output: Contribution to journalArticle

Abstract

Purpose: Surgical decision-making in Chiari malformation type I (CM-I) patients tends to depend on the presence of neurological signs and symptoms, syringomyelia, and/or scoliosis, but significant variability exists from center to center. Here, we review the symptoms of CM-I in children and provide an overview of the differences in opinion regarding surgical indications, preferred surgical techniques, and measures of outcome. Methods: A review of the literature was performed to identify publications relevant to the surgical management of pediatric CM-I patients. Results: Most surgeons agree that asymptomatic patients without syringomyelia should not undergo prophylactic surgery, while symptoms of brainstem compression and/or lower cranial nerve dysfunction warrant surgery. Patients between these extremes, however, remain controversial, as does selection of the most appropriate surgical technique. Conclusions: The optimal surgical procedure for children with CM-I remains a point of contention, and widespread variability exists between and within centers.

Original languageEnglish (US)
JournalChild's Nervous System
DOIs
Publication statusPublished - Jan 1 2019

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Keywords

  • Chiari
  • Duraplasty
  • Scoliosis
  • Syringomyelia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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