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International Journal of Pediatrics
Volume 2012 (2012), Article ID 640127, 10 pages
http://dx.doi.org/10.1155/2012/640127
Review Article

Surgical Management of Patients with Chiari I Malformation

1Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Biopolis, 41110 Larissa, Greece
2Department of Diagnostic Radiology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larisa, Greece
3Institute of Biomedical Research and Technology (BIOMED), Center for Research and Technology—Thessaly (CERETETH), 38500 Larissa, Greece

Received 16 January 2012; Revised 16 April 2012; Accepted 30 April 2012

Academic Editor: Sheffali Gulati

Copyright © 2012 John Siasios et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chiari malformations (CMs) constitute a variety of four mainly syndromes (I, II, III, and IV), which describe the protrusion of brain tissue into the spinal canal through the foramen magnum. These malformations frequently occur in combination with other pathological entities such as myelomeningocele, hydrocephalus, and/or hydrosyringomyelia. The recent improvement of imaging techniques has increased not only the rate of CM diagnosis but also the necessity for its early treatment. Several different surgical techniques have been employed in the treatment of patients with symptomatic CM-I. In our current study, a systematic and critical review of the pertinent literature was made for identifying the most commonly employed surgical procedures in the management of these patients. Emphasis was given in outlining the advantages and disadvantages of each surgical approach. Moreover, an attempt was made for defining those parameters that may be prognostic factors for their surgical outcome. There is a consensus that surgical treatment is reserved only for symptomatic patients with CM-I. It has also been postulated that early surgically intervention is usually associated with better outcome. Despite the large number of previously published clinical series, further clinical research with large-scale studies is necessary for defining surgical treatment guidelines in these patients.