Abstract
The decision on whether or not to operate children with Chiari type I malformation (CIM) is difficult and controversial, because of the lack of information about the natural evolution of such a disease. Herein, we report on the evolution of 16 asymptomatic children with incidentally diagnosed CIM (mean age: 6.7 years; mean follow-up: 5.8 years). No patients required suboccipital decompression. Thirteen children remained asymptomatic, with stable or improved radiological picture (worsening in 2 cases). Three cases showed appearance of symptoms: one did not require any treatment; the remaining two underwent endoscopic third ventriculostomy because of hydrocephalus, which is a possible consequence of CIM. This analysis shows a favorable natural outcome of CIM in children, thus suggesting a conservative management in asymptomatic cases. However, multicentric studies are required to validate this data.
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Massimi, L., Caldarelli, M., Frassanito, P. et al. Natural history of Chiari type I malformation in children. Neurol Sci 32 (Suppl 3), 275–277 (2011). https://doi.org/10.1007/s10072-011-0684-3
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DOI: https://doi.org/10.1007/s10072-011-0684-3