Clinical Outcome for surgical treatment of Chiari type 1 malformation in symptomatic adult patients

Chiari malformation type 1 is characterized by more than 5 millimeter downward displacement of the cerebellar tonsils from foramen magnum.

In a retrospective study, 46 adult patients (16 female and 20 men) with clinical and radiologic signs of Chiari malformation type 1 were entered to our registry between April 2009 and March 2015. They were all examined, diagnosed and operated (suboccipital decompression with or without duraplasty) in Ghaem hospital, Mashhad, Iran. Primary presentation and clinical outcome were reviewed in 24 patients that were subsequently followed.

Mean age of our patients were 36.4 years (range 18-52 years).Median duration of symptoms before the surgery was 50.12±63.6 months. Headache and neck pain and sensory deficit were the most common clinical presentations. At follow up, 83 percent of patients (18/24) have good clinical outcome. Statistical analysis revealed no statistical difference between suboccipital decompression surgery with duraplasty and without duraplasty. (P=0.82) Postoperatively, headache and neck pain and voice abnormality showed highest improvement.

Although Chiari Malformation is not common, the disease should be consider in the differential diagnosis in patients with nonspecific headache and neck pain. Clinical outcome in the patients is favorable.