Chiari Malformation Treatments

Symptoms are especially important in determining the most appropriate treatment for a Chiari malformation. For example, if you have a Type I Chiari malformation and no symptoms, regular monitoring and surveillance imaging may be all you need. We’ll educate you about your condition and keep a close eye on you, but it’s unlikely that your Chiari malformation will need treatment.

When symptoms are affecting your quality of life and treatment becomes necessary, it’s important to have a team of experts on your side, working together and exploring every angle, because a clear treatment path isn’t always obvious. UT Southwestern’s interdisciplinary team will review your case from a host of perspectives. Our neurologists, neurosurgeons, neuroradiologists, and others work together and with you to determine the best course of action.

Surgical Options

When surgery is needed to treat a Chiari malformation, the goal is to stop progressive displacement of brain tissue into the spinal canal (spinal synapses). This restores the normal flow of cerebrospinal fluid, and to ease or stabilize symptoms.

Surgical options include:

  • Foramen magnum decompression – The most common operation to treat a Chiari malformation. It involves the removal of a small piece of the skull to relieve pressure on the spinal cord. If further decompression is necessary, we’ll open the dura, the tissue that covers and protects the brain and spinal cord, to further reduce the pressure, then sew a patch over the new dural opening, allowing even more room for cerebrospinal fluid circulation.
  • Laminectomy ­– If your cerebellar tonsils extend far into your spinal canal, we may remove the first cervical lamina to make more room.
  • Shunt – In some cases, patients may need a shunt to drain excessive cerebrospinal fluid away from the skull and brain to another part of the body where it can be absorbed. We may implant a shunt before decompression surgery to relieve pressure and improve symptoms; sometimes, implanting the shunt allows us to avoid surgery altogether.

After surgery, you’ll spend time recovering in our dedicated neurocritical care unit (neuro ICU), and work with our neurorehabilitation specialists when you’re ready.

Request an Appointment

To schedule an appointment with a Chiari malformation specialist at UT Southwestern’s facilities in Dallas, or to learn more about our services, request an appointment or call 214-645-8300.