ReviewChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2023
Acquired Chiari type I malformation: a late and misunderstood supratentorial over-drainage complication.
Review in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 4 citations in OpenAlex.
- Evaluating CSF Flow (Cine MR) and Clinical Outcomes in Patients with Chiari Type 1 Who Underwent Dural Relaxation or Durotomy.Brain sciences · 2026Article
- Secondary Chiari-like formation caused by grafted bone overgrowth following occipitocervical fixation: a rare cause of pediatric quadriplegia.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Sinking skin flap syndrome masquerading as Chiari malformation: failed syringomyelia treatment rescued by cranioplasty. Illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Applications of Machine Learning in the Diagnosis and Prognosis of Patients with Chiari Malformation Type I: A Scoping Review.Children (Basel, Switzerland) · 2025Review
- A Critical Update of the Classification of Chiari and Chiari-like Malformations.Journal of clinical medicine · 2023Review
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7 authors at 3 institutions in 1 country.
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Abstract
purposeAcquired Chiari I malformation is an uncommon but possible late complication of supratentorial shunting in children. This condition can be caused by an abnormal thickening of the cranial vault and consequent reduction of the posterior cranial fossa (PCF) volume especially in children with already a small PCF volume. The management of Acquired Chiari I malformation is very challenging, and several options have been proposed for this condition. These are aimed to expand the PCF volume both through decompression and PCF remodeling in order to relieve symptoms of acquired Chiari I malformation. A cranial vault remodeling or a standard Chiari decompression is two proposed techniques aimed to expand the PCF volume thus relieving symptoms .
methodsWe describe the case of a 16-year-old girl undergone surgical removal of sellar-suprasellar glioneuronal tumor and ventriculo-peritoneal shunting, who developed an acquired symptomatic Chiari type I malformation some years after ventricular-peritoneal shunting. For this condition, she underwent successful standard Chiari decompression with C0-C1 craniectomy and duroplasty.
resultsWe retrospectively analyzed MRI and CT scan performed during follow-up, in order to evaluate the volume of the posterior cranial fossa and to measure the variation of skull thickness at different periods. MRI and CT scan analysis showed a progressive thickening of the calvaria, in particular of the occipital bone, leading to a progressive reduction of PCF volume with the establishment of acquired Chiari type I malformation. In this case, standard C0-C1 Chiari decompression was effective in restoring PCF volume and relieving symptoms.
conclusionAcquired Chiari I malformation due to chronic overhunting could be a severe and late complication in patient undergone supratentorial shunting. These patients require careful clinical and radiological follow-up to avoid over-drainage. According to our analysis, a careful selection of pediatric patients for supratentorial shunting should be made according to pre-operative PCF volume in order to foresee higher odds of possible late complications from over-drainage.
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