Chiari malformations in children: An overview

Abstract BACKGROUND Different conditions of the posterior fossa such as Chiari malformations, tumors, and arachnoid cysts require surgery through a suboccipital approach, for which a typical midline vertical linear incision is used. Curvilinear incisions have been carried in all other scalp regions other than the sub region for better cosmetic outcomes; a vertical curvilinear incision in the occipital and suboccipital region has not been reported. OBJECTIVE To evaluate the cosmetic value and safety of the “3 on a stick” vertical suboccipital curvilinear incision. METHODS We compared curvilinear to linear incisions, considering the scar's width, color, how conspicuous, and how well the scar could be covered by hair naturally. RESULTS Between 2010 and 2016, 68 children with Chiari I malformation were surgically intervened. The curvilinear incision was performed in 56 (82.4%) while a linear incision in 12 (17.6%) children. There were only 2 (2.9%) wound related complications (superficial dehiscences) in the curvilinear group and 1 additional dehiscence in a linear incision case. There were no neural or vascular complications. Scars were very similar among the 2 groups; both were equally conspicuous but curvilinear ones seemed to get covered better by hair. CONCLUSION The “3 on a stick” curvilinear incision of the suboccipital region is safe and allows for better hair coverage of the scar. It can be used for multiple conditions requiring a midline suboccipital or even occipital approach, such as Chiari malformations, tumors, and cysts.

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INIENCEPHALY AND THE CHIARI MALFORMATIONS, A SPECTRUM OF RELATED DEFECTS

Journal of Neuropathology & Experimental Neurology ◽

10.1097/00005072-199005000-00140 ◽

1990 ◽

Vol 49 (3) ◽

pp. 305

Author(s):

M. Ahdab-Barmada ◽

D. Claassen ◽

J. Moossy

Keyword(s):

Chiari Malformations

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The Association of Chiari Type I Malformation and Neurofibromatosis Type 1

Clinical Pediatrics ◽

10.1177/000992289303200316 ◽

1993 ◽

Vol 32 (3) ◽

pp. 189-190 ◽

Cited By ~ 9

Author(s):

Joseph Dooley ◽

Daniel Vaughan ◽

Michael Riding ◽

Peter Camfield

Keyword(s):

Neurofibromatosis Type 1 ◽

Chiari Malformation ◽

Neurofibromatosis Type ◽

Foramen Magnum ◽

Type I ◽

Chiari Type ◽

Chiari Type I Malformation ◽

Chiari Type I ◽

Chiari Malformations

The association of neurofibromatosis type 1 (NF1) with Chiari malformations of the cerebellum and brain stem has been reported on only two previous occasions.1,2 The pathogenesis of both conditions has remained unclear, although the Chiari type I malformation is most likely due to hypoplasia of the posterior fossa with subsequent extension of the cerebellum through the foramen magnum.3 NF1 is also associated with a variety of cerebral dysplasias.4 We present a patient with both of these dysplastic lesions whose Chiari malformation was asymptomatic.

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