Resolution of papilledema after neurosurgical decompression for primary Chiari I malformation.
OBJECTIVE
To report a causal relationship between Chiari I malformation and its rare, but recognized manifestation of bilateral papilledema.


METHODS
Interventional case series.


METHODS
Four adult female patients (mean age, 48, age range 25-59 years) with bilateral papilledema, signs and symptoms of increased intracranial pressure, and cranial magnetic resonance imaging (MRI) evidence of a Chiari I malformation ranging from 7 to 22 mm of tonsillar herniation underwent suboccipital decompression.


RESULTS
In all four patients, suboccipital decompression was followed by resolution of bilateral papilledema and signs and symptoms of increased intracranial pressure.


CONCLUSIONS
Patients with bilateral papilledema and presumed pseudotumor cerebri require a cranial MRI to determine if they have a Chiari I malformation, because patients with increased intracranial pressure and papilledema from a Chiari I malformation may benefit from suboccipital decompression.
Vaphiades
Micheal S
MS
Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205-7199, USA. mvaphiades@uams.edu
Eggenberger
Eric R
ER
Miller
Neil R
NR
Frohman
Larry
L
Krisht
Ali
A
D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001794:Blood Pressure; D019299:Decompression, Surgical; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D007427:Intracranial Pressure; D007429:Intraocular Pressure; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010211:Papilledema / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012189:Retrospective Studies