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J Neurosci Rural Pract. 2019 Jan-Mar;10(1):85-88. doi: 10.4103/jnrp.jnrp_160_18.

Surgical Experience in Pediatric Patients with Chiari-I Malformations Aged ≤18 Years.

Author information

Department of Neurosurgery, JIPMER, New Delhi, India.
Department of Anaesthesia and Critical Care, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India.
Department of Pathology, Sanjay Gandhi Hospital, New Delhi, India.
Department of Obstetrics and Gynaecology, Maharaja Agrasen Hospital, New Delhi, India.
Department of Neurosurgery, Maharaja Agrasen Hospital, New Delhi, India.



The objective of this study was to retrospectively study Chiari I malformation patients (<18 years) treated surgically.

Materials and Methods:

Chiari I malformation patients (<18 years) treated surgically at our institute were retrospectively studied.


During the study period between January 1999 and June 2011, fifty patients, aged ≤18 years with Chiari malformation, were treated surgically and formed the basis for this series. There were 21 female children (42%) and 29 male children (58%), with a female-to-male ratio of 1:1. At the last follow-up, oropharyngeal symptoms were improved in 33% (n = 3/9). Headache/neck/back pain improved in 69.56% of children (n = 16/23). Upper-extremity pain/weakness/numbness improved in 73.91% of children (n = 17/23). Ataxia improved in 66.66% of children (n = 4/6). Lower-limb weakness/hyperreflexia improved in 83.33% of children (n = 5/6). At follow-up, magnetic resonance imaging for patients with syrinx was available for 75% of patients (n = 30/50) and not available for 25% of patients (n = 10/40). Syrinx was diminished in size or resolved in 66.33% of patients (n = 19/30) and the remaining was same for 36.66% of patients (n = 11/30).


The main goal of surgery is to arrest the progression of neurological deficits. Foramen magnum decompression with a lax duroplasty is the surgical procedure of choice.


Chiari malformation; duroplasty; pediatric

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