Long-term outcome after surgery for Chiari I malformation.
OBJECTIVE
To examine the long-term effects of suboccipito-cervical decompression on an intention-to-treat basis in patients with Chiari I malformation (CMI).


METHODS
Twenty-four consecutive patients, 14 females and 10 males with a median age of 26 years, underwent decompressive surgery for CMI during 1998-2006. All patients were contacted by an independent examiner and asked to complete a questionnaire regarding headache, other neurological symptoms and negative impact of the disease on the daily life before and after surgery. The median follow-up time after surgery was 3.2 years (range 1.7-9.2 years). Twenty-three patients (96%) completed the questionnaire.


RESULTS
On an intention-to-treat basis there was an improvement in headache in 75%, decreased associated neurological symptoms in 88% and less negative impact on daily life in 75% of the 24-operated patients.


CONCLUSIONS
More than three-quarters of the patients still considered their situation improved at long-term follow-up after surgery. These results support surgical intervention in symptomatic Chiari I patients.
Tisell
M
M
Hydrocephalus Unit, Institute of Clinical Neuroscience, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
Wallskog
J
J
Linde
M
M
D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome