Chiari Malformation: How We Treat

How is Chiari Malformation Type 1 treated?

In most cases, Chiari Malformation Type 1 (CMI) does not require any treatment because it does not cause symptoms or pain that affect a child's life. In the cases that do require treatment, surgery is the first option because there are no other effective medical therapies.

What to expect from surgery

The goal of surgery is to provide more space for the small portion of the brain (cerebellar tonsils) that extends into the spinal canal. This also allows for better flow of the cerebrospinal fluid at the junction of the skull and spine. This fluid is a normal an important part of the brain and nervous system.

During surgery a small portion of the bone at the back of the skull and first bone of the neck are removed. At this point, there is an option to open the outermost protective layer of the brain (called the dura mater) or to thin this layer without opening it completely in order to provide more space for important brain structures.

Opening the protective tissue layer and sewing in a patch to make the space larger is called duraplasty. The surgical procedure is called "posterior fossa decompression with or without duraplasty." The decision to perform duraplasty is tailored for each patient based on symptoms, the characteristics of the malformation seen on imaging tests, and a discussion with the patient and parents.

Why choose Children's Hospital Colorado for your child's Chiari malformation?

Children's Colorado has the largest and most experienced pediatric neurosurgical faculty in Colorado. Our team cares exclusively for children with neurosurgical problems, and we perform the most pediatric neurosurgical procedures of any hospital in a six-state region.

Our staff has extensive experience performing the corrective surgery for Chiari Malformation Type 1 (CMI) and has written medical research papers regarding the procedure. We are also a member of the largest research group in the United States that is studying children with CMI.