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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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021724 | PMC |
| http://dx.doi.org/10.1007/s00381-016-3138-7 | DOI Listing |
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