• PotgieserAdriaan R EARDepartment of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands. a.r.e.potgieser@umcg.nl. and Eelco W Hoving.
• Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands. a.r.e.potgieser@umcg.nl.
• Childs Nerv Syst. 2016 Sep 1; 32 (9): 1721-5.

PurposeThe 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.MethodsWe illustrate three cases of symptomatic acquired Chiari I malformation due to inward cranial vault thickening.ResultsWe 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.ConclusionInternal 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.

17 keywords...

hide…