Chiari I malformation: surgical experience over a decade of management

Abstract

Chiari malformations are a pathological continuum of hindbrain maldevelopment and Chiari I malformation (CMI) represents caudal decent of cerebellar tonsils. The surgery aims to relieve tonsillar compression with restoration of the normal cerebrospinal (CSF) flow dynamics. We report the salient features of our surgical experience with CMI; over a decade of management of 87 patients. Most (57) presented with pain and weakness was predominant motor complaint (n = 34). The associated bony anomalies were seen in 25 patients. For clinical grading and outcome analysis, modified Klekamp and Samii scoring system was used. The majority of patients were in poor grades (n = 43); 79 patients improved following surgical intervention at a mean follow-up of 34.21 + 21.53 months. The bony decompression and establishment of CSF flow dynamics are needed, and posterior fossa decompression in symptomatic patients offers success in the majority of patients with minimal complications.