The surgical treatment of Chiari I malformation

@article{Klekamp2005TheST,
  title={The surgical treatment of Chiari I malformation},
  author={J{\"o}rg Klekamp and Ulrich Batzdorf and Madjid Samii and Hans W Bothe},
  journal={Acta Neurochirurgica},
  year={2005},
  volume={138},
  pages={788-801}
}
SummaryA retrospective study was undertaken on 133 patients with a Chiari I malformation treated within the last 16 years at the Departments of Neurosurgery at the Nordstadt Hospital Hannover, Germany, and the University of California, Los Angeles, U.S.A. Ninety-seven patients presented with symptoms related to accompanying syringomyelia and 4 with associated syringobulbia. They underwent 149 surgical procedures and were followed for a mean of 39±52 months. A decompression at the foramen magnum… 
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Surgical treatment of Chiari malformation with and without syringomyelia: experience with 177 adult patients.
TLDR
Surgical decompression of the posterior fossa should aim to create relatively large subarachnoid cisterns and reduce the size of the syrinx cavity, and reduction of the cerebellar tonsils by surgical means achieves this goal and thereby improves the clinical outcome for patients with CM.
Long-term surgical outcome of Chiari type-I malformation-related syringomyelia: an experience of tertiary referral hospital
TLDR
Early diagnosis of patients with CRS can improve surgical outcomes and PFDD is still an optimal surgical approach for CRS, due to its efficacy in resolving clinical symptoms and syrinx cavities.
Outcome of Two Surgical Options Used in Treatment of Chiari Type-One Malformation
TLDR
Suboccipital craniectomy, C1 laminectomy, and duraplasty for the treatment of Chiari I malformation may benefit more the group of patients with associated syringomyelia, compared with Suboccipitals Craniectomy and C1 Laminectomy alone.
Surgical Treatment in Symptomatic Chiari Malformation Type I: A Series of 25 Adult Patients Treated with Cerebellar Tonsil Shrinkage.
TLDR
Cerebellar tonsil reduction and restoration of cerebrospinal fluid (CSF) circulation provided clinical improvement and a stable reduction in the syrinx size in the vast majority of treated patients, with a low rate of complications.
Chiari I Malformation: Part II
TLDR
Treatment The correct treatment for Chiari I malformation is one of the most disputed issues in neurosurgery, and given that the surgical procedures currently used for treating this malformation have demonstrated no serious complications in experienced hands, most authors advocate early intervention.
Relevance of surgical strategies for the management of pediatric Chiari type I malformation
TLDR
Duraplasty and tonsillar reduction were equally effective but significantly better than bone decompression alone in Chiari type I malformation, and among patients with syringomyelia, tonsillsar reduction was associated with a significantly better outcome.
Surgical outcomes after posterior fossa decompression with and without duraplasty in Chiari malformation-I
The fate of syringomyelia after surgical treatment of syringomyelia–Chiari I complex
TLDR
The extra-arachnoidal technique has proved to be a safe, and effective means of treating patients with syringomyelia–Chiari I complex allowing the syrinx to decrease in size or collapse in the majority of cases with an associated improvement in many of the neurological disturbances.
Clinical outcomes in patients with Chiari I malformation: a review of 27 cases.
Surgical results of posterior fossa decompression for patients with Chiari I malformation
TLDR
Overall, this work favors a tailored posterior fossa craniectomy with dural scoring as the initial surgical procedure in children with Chiari I malformation with or without a syrinx.
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