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Chiari 1 malformation and raised intracranial pressure

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Abstract

Background

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.

Objectives

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.

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Acknowledgments

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

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  1. Department of Paediatric Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Level 3, West Wing, Headley Way, Oxford, OX3 9DU, UK

    Rory J. Piper & Shailendra A. Magdum

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  1. Rory J. Piper
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Correspondence to Shailendra A. Magdum.

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Piper, R.J., Magdum, S.A. Chiari 1 malformation and raised intracranial pressure. Childs Nerv Syst 35, 1719–1725 (2019). https://doi.org/10.1007/s00381-019-04232-x

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