Skull Base 2003; 13(3): 173-178
DOI: 10.1055/s-2003-43328
TECHNICAL NOTE

Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Surgical Treatment of Chiari I Malformation: Simplified Technique and Clinical Results

Michael B. Pritz
  • Indiana University School of Medicine, Section of Neurological Surgery, Indianapolis, Indiana
Further Information

Publication History

Publication Date:
18 May 2004 (online)

ABSTRACT

A simplified technique for decompressing the posterior fossa and foramen magnum in symptomatic patients with a Chiari I malformation is described. The approach uses a curvilinear dural incision and an autologous pericranial graft. This procedure was used in 14 symptomatic patients, 8 of whom had a cervical or cervicothoracic syrinx. Neurologic signs and symptoms improved or were unchanged in all patients. The size of the syrinx decreased in all patients. No patient developed a new neurologic deficit, cerebrospinal fluid leak, pseudomeningocele, or infection. Postoperatively, one patient developed new, dysesthetic, unilateral arm pain that did not require medication. This technique has several advantages. The procedure is simple and requires a single skin incision. Autologous graft can be used. The occipital sinus can be avoided. Finally, the contralateral region remains pristine if a repeat procedure becomes necessary.

REFERENCES

  • 1 Batzdorf U. Syringomyelia, Chiari malformation, and hydromyelia. In: Youmans JR, ed. Neurological Surgery: A Comprehensive Reference Guide to the Diagnosis and Management of Neurosurgical Problems 4th ed. Philadelphia, PA: WB Saunders; 1996: 1090-1109
  • 2 Ellenbogen R G, Zeidman S M. Craniovertebral decompression for Chiari malformation. In: Kaye AH, Black PMcL, eds. Operative Neurosurgery New York, NY: Churchill Livingstone; 2000: 1725-1741
  • 3 Batzdorf U. Microsurgery of syringomyelia and syringomyelia cord syndrome. In: Schmidek HH, ed. Schmidek & Sweet Operative Neurosurgical Techniques: Indications, Methods, and Results4th ed. Philadelphia, PA: WB Saunders; 2000: 1946-1954
  • 4 Rhoton Jr L A. Microsurgery of syringomyelia and the syringomyelia-Chiari complex. In: Schmidek HH, ed. Schmidek & Sweet Operative Neurosurgical Techniques: Indications, Methods, and Results4th ed. Philadelphia, PA: WB Saunders 2000: 1955-1969
  • 5 Milhorat T H, Chou M W, Trinidad E M. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients.  Neurosurgery . 1999;  44 1005-1017
  • 6 Kempe L G. Operative Neurosurgery.  Vol 2: Posterior Fossa, Spinal Cord, and Peripheral Nerve Disease. New York, NY: Springer-Verlag; . 1970;  14-23
  • 7 Heiss J D, Patronas N, DeVroom H L. Elucidating the pathophysiology of syringomyelia.  J Neurosurg . 1999;  91 553-562