{"id":"7d4ceaf7-746a-4e1e-90de-8a6c4eb31241","slug":"controversies-in-chiari-i-malformations","title":"Controversies in Chiari I malformations","authors":["Jamie Baisden"],"abstract":"Background: The diagnosis and management of Chiari I malformations (CMI) remains controversial, particularly since it is often an incidental finding on cervical MR scans performed for neck pain and/or headaches. Recently, some surgeons “over-operated” on asymptomatic patients with Chiari I malformations, or even on those without the requisite radiographic diagnostic features for Chiari I malformations: unfortunately, only a subset were admonished for indiscriminate surgery. Nevertheless, when this hindbrain malformation is truly symptomatic, contributing to impaired cerebrospinal fluid (CSF) circulation, various valid surgical management strategies may be adopted. Methods: This review focuses on the current literature regarding the clinical presentation, diagnosis, and surgical management of Chiari I malformation. Variations in the surgical technique are also presented and critiqued. Results: The recommended treatment for Chiari I malformations I consists of decompressive suboccipital craniectomy and duroplasty when abnormal cine-flow MRI is observed preoperatively and blockage of CSF flow persists intraoperatively despite bony decompression. Conclusions: Controversy continues regarding the optimal surgical technique to address Chiari malformations I. Proper diagnostic studies and patient selection are needed to optimize patient outcomes, while avoiding unnecessary surgical procedures.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/7d4ceaf7-746a-4e1e-90de-8a6c4eb31241/featured/hero-1782421032970.png","publishDate":"2012-07-17T00:00:00.000Z","doi":"10.4103/2152-7806.98580","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/3547/SNI-3-232.pdf"}