Posterior Fossa Reconstruction for Chiari Malformation Type I: Experience with 17 Cases
Keywords:
Type I Arnold – Chiari malformation,, Posterior cranial fossa,, De-compressive craniectomy, con-genital abnormalityAbstract
Objective: To assess the results of posterior fossa reconstruction in patients with Chiari I malformation.
Material and Methods: This observational study was conducted at the department of Neurosurgery, medical and teaching institute (MTI), Lady Reading Hospital Peshawar from July 2013 to June 2015. A total of 17 consecutive patients with Chiari I malformation who undergone posterior fossa reconstruction and fulfilled inclusion criteria were included in the study irrespective of their age and gender. The patients were assessed postoperatively for clinical and radiological (syringomyelia) improvement and post operative complications for a period of 6 months.
Results: We had total 17 patients who underwent posterior fossa reconstruction for Chiari I malformation. There were 41.2% males and 58.8% females. Age of the patients ranged from 10 – 52 years with the mean age of 31 years. The most common clinical features were headache (64.7%) and sensory impairment (58.8%). We had syringomyelia in 70.1% and scoliosis in 47.1% cases. After surgery headache improved in 81.1% patients, sensations in 70% cases and syringomyelia in 91.1% cases. The overall morbidity in the form of complications was in almost 47% cases. One patient (5.9%) died after surgery.
Conclusions: We conclude that posterior fossa reconstruction is a safe and effective procedure for the manage-ment of Chiari I malformation. This results in improvement in patients symptoms with acceptable complications. These complications respond to conservative treatment most of time
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