Natalia Fourla, Dimosthenis Chrysikos, Vasilis Protogerou, Ioannis Michalis, Maria Karamanidi, Nikolaos Paidakakos and Theodore Troupis*
Objective: Chiari Malformation type 1 is a clinical entity characterized by impaired circulation of the cerebrospinal fluid through the foramen magnum. Traditionally, the syndrome has been characterized by herniation of the cerebellar tonsils into the spinal canal. The treatment is principally surgical. Different operative techniques have been evaluated with decompressionof the posterior fossa and foramen magnum. Materials and methods: This study aims to evaluate surgical treatment options of patients with Chiari malformation type 1using various decompression techniques, and to review the current literature for the reported outcomes. The review was conducted on the basis of database research in PubMed without limitation regarding the year of publication. A search strategy was used including the terms (Chiari I) or (Chiari type 1) and (post-surgical outcome) or (decompression surgery). 90 articles were retrieved of which 50 were directly related to our research objective. By applying exclusion criteria, 20 articles were found to define the benefits of a surgical procedure over conservative treatment in the presence of Chiari type 1 malformation. Results: According to the literature, the main indication for surgical treatment was the presence of clinical findings attributed to Chiari malformation, with respect to the radiological findings. A low middle line sub-occipital craniectomy was always performed, with or without duroplasty. However, according to many authors, the possible complications of the intradural technique must always be taken into consideration before surgical planning. Conclusion: In general, there was a favorable outcome after decompressive surgery associated with syrinx resolution.