title: Chiari III malformation: a comprehensive review of this enigmatic anomaly.
abstract: BACKGROUND
  Chiari III is one of the rarest of the Chiari malformations and is characterized by a high cervical or low occipital encephalocele and osseous defect with or without spinal cord involvement and may include many of the anatomical characteristics seen in the Chiari II malformation. Herein, we provide a comprehensive review of this rare anomaly as well as a translation of Chiari's original description.
  
  
  METHODS
  We review all reported cases of Chiari III malformation found in the extant literature.
  
  
  CONCLUSIONS
  Out of 57 reported cases of Chiari III malformation, encephaloceles were in a high cervical/low occipital position in 23, 8 were in a high cervical position, 17 were in low occipital position, and the position in 9 cases was not reported. The pathogenesis of Chiari III malformation remains unclear. The majority of patients have concomitant hydrocephalus. Brain parts occurring in the sac from the most to least common include the following: cerebellum, occipital lobe, and parietal lobe. The severity of symptoms is correlated with the amount of brain structures within the encephalocele. Neurologic functional outcomes have been varied and depend on the neurological status of the patient before surgery.
authors.affiliation: Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA.
authors.forename: Galyna
authors.initials: G
authors.lastname: Ivashchuk
authors.affiliation: Department of Anatomical Sciences, St. George's University, St. George, Grenada.
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.affiliation: Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Blount
authors.affiliation: Seattle Science Foundation, Seattle, WA, USA. shane.tubbs@childrensal.org.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.affiliation: Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA.
authors.forename: W Jerry
authors.initials: WJ
authors.lastname: Oakes
mesh_terms: D001139:Arnold-Chiari Malformation / Q000209:etiology / Q000266:history / Q000473:pathology* / Q000628:therapy; D001921:Brain / Q000002:abnormalities*; D049672:History, 19th Century; D006801:Humans; D008279:Magnetic Resonance Imaging
keywords: Cervical encephalocele; Chiari III malformation; Clinical manifestations; MRI; Pathogenesis; Prognosis; Surgical treatment