Symptomatic Subdural Hygroma and Hydrocephalus following Chiari I Decompression.
BACKGROUND
The aim of the present case report is to describe an unusual complication of foramen magnum decompression (FMD) for the Chiari 1 hindbrain malformation and its successful management with non-operative measures.


METHODS
A 2-year-old girl with the Chiari 1 malformation underwent FMD, including suboccipital craniotomy, C1 laminectomy and durotomy without opening the arachnoid.


RESULTS
After initial postoperative improvement, the patient deteriorated, developing subdural hygromas and hydrocephalus. These were treated successfully with observation and acetazolamide.


CONCLUSIONS
Subdural hygromas may complicate FMD. A slit valve opening in the arachnoid might be part of the pathophysiology. While surgical intervention may be necessary in some circumstances, non-operative measures may be effective as well.
Filis
Andreas K
AK
Division of Pediatric Neurosurgery, Rainbow Babies and Children's Hospital, The Neurological Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
Moon
Karam
K
Cohen
Alan R
AR
D000086:Acetazolamide / Q000627:therapeutic use; D001139:Arnold-Chiari Malformation / Q000175:diagnosis / Q000601:surgery*; D002675:Child, Preschool; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005539:Foramen Magnum / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008991:Monitoring, Physiologic / Q000379:methods; D019370:Observation / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D013353:Subdural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
D000086:Acetazolamide