Acquired Chiari type I malformation managed by expanding posterior fossa volume and literature review
The acquired Chiari type I malformation is a rare late complication of supratentorial shunting in children which is often accompanied by abnormal cranial vault thickening. Several surgical treatments for this disease have been proposed including supratentorial skull enlarging procedures and subtentorial craniotomy. But there is still debate about the best treatment strategy for this disease.
Method and results
We reviewed the current knowledge of this disease in the paper. We illustrated one patient of symptomatic acquired Chiari type I malformation who had cysto-peritoneal (C-P) shunting and ventriculoperitoneal (V-P) shunting. We observed the CSF flow dynamic of this patient at different periods. The acquired Chiari type I malformation disappeared on imaging after thinning the occipital planum combined with the standard surgical therapy of Chiari decompression. The symptoms of the patient were relieved after surgery.
Overshunting manifestations require prompt recognition and management. Preventive measures should be taken which include making a stringent selection of cases being considered for surgery, avoiding C-P drainage, and placing of a programmable valve as initial treatment of intracranial arachnoid cysts (AC) if shunting is considered.
KeywordsChiari type I malformation Decompression Shunting Arachnoid cyst Hydrocephalus
The study was supported by Science and education program of Suzhou (KJXW2017023).
Compliance with ethical standards
Conflict of interest
The authors received no financial and/or material support for the research reported in this paper. The authors state that there are no conflicts of interest arising from the research reported in this paper.
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Consent for publication
Written informed consent was obtained from the patient for the publication of this case report and accompanying images.
A copy of the written consent is available for review by the Editor-in-Chief of this journal.