Chiari decompression surgery is a specific type of craniotomy designed to make more room for the herniated cerebellum that occurs when a patient has Chiari malformation and to relieve pressure on the brain. It also may permit restoration of the normal flow of cerebrospinal fluid (CSF) around the brain.
Many children with Chiari malformation do not experience symptoms and may never require medical treatment. However, those with more severe symptoms should be treated by a neurosurgeon to determine whether surgery is appropriate. Chiari decompression surgery is the most common treatment for the condition.
Chiari decompression surgery removes bone at the back of the skull to widen the foramen magnum and create space for the brain. The dura overlying the herniated tonsils is opened and a patch is sewn to expand the space, similar to letting out the waistband on a pair of pants. The goals of surgery are to control the progression of symptoms, relieve compression, and restore the normal flow of cerebrospinal fluid (CSF). The surgery takes about two to three hours and recovery in the hospital usually lasts two to four days.