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Childs Nerv Syst. 2016 Sep;32(9):1721-5. doi: 10.1007/s00381-016-3138-7. Epub 2016 Jun 11.

A novel technique to treat acquired Chiari I malformation after supratentorial shunting.

Author information

1
Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands. a.r.e.potgieser@umcg.nl.
2
Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.

Abstract

PURPOSE:

The acquired Chiari I malformation with abnormal cranial vault thickening is a rare late complication of supratentorial shunting. It poses a difficult clinical problem, and there is debate about the optimal surgical strategy. Some authors advocate supratentorial skull enlarging procedures while others prefer a normal Chiari decompression consisting of a suboccipital craniectomy, with or without C1 laminectomy and dural patch grafting.

METHODS:

We illustrate three cases of symptomatic acquired Chiari I malformation due to inward cranial vault thickening.

RESULTS:

We describe a new surgical approach that appears to be effective in these patients. This approach includes the standard Chiari decompression combined with posterior fossa augmentation by thinning the occipital planum.

CONCLUSION:

Internal volume re-expansion of the posterior fossa by thinning the occipital planum appears to be an effective novel surgical strategy in conjunction with the standard surgical therapy of Chiari decompression.

KEYWORDS:

Acquired Chiari I malformation; Cranial vault thickening; Ventriculoperitoneal shunt

PMID:
27289362
PMCID:
PMC5021724
DOI:
10.1007/s00381-016-3138-7
[Indexed for MEDLINE]
Free PMC Article

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