Chiari 1 malformation and raised intracranial pressure

  • Rory J. Piper
  • Shailendra A. MagdumEmail author
Special Annual Issue



The pathophysiology of Chiari 1 malformation (CM1) is inextricably related to intracranial pressure (ICP). The characteristic cerebellar tonsil herniation at the foramen magnum may either cause raised ICP by disturbing CSF flow (as observed in idiopathic CM1) or may itself be the effect of raised ICP (as observed in acquired CM1). Distinguishing between these two phenomena, therefore, is of paramount importance in successfully alleviating the symptoms of the condition and preventing serious complications.


In this article, we discuss the pathophysiology of raised ICP in CM1 and review the current evidence for its investigation and treatment. We also share our own clinical experience which investigates the utility of ICP monitoring in a series of 26 children with CM1.


Chiari 1 malformation Hydrocephalus Intracranial pressure 



Rory J. Piper is supported by an NIHR Academic Clinical Fellowship.

Compliance with ethical standards

Conflict of interest

None to declare.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Paediatric Neurosurgery, John Radcliffe HospitalOxford University Hospitals NHS Foundation TrustOxfordUK

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