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Child's Nervous System
Published in: Child's Nervous System 9/2016

Open Access 01-09-2016 | Technical Note

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

Authors: Adriaan R. E. Potgieser, Eelco W. Hoving

Published in: Child's Nervous System | Issue 9/2016

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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.
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Metadata
Title
A novel technique to treat acquired Chiari I malformation after supratentorial shunting
Authors
Adriaan R. E. Potgieser
Eelco W. Hoving
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 9/2016
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-016-3138-7

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