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Arnold Chiari Malformation Liew Boon Seng 20 SEPTEMBER 2006 Continuous Medical Education Department of Neurosurgery, Hospital Kuala Lumpur

Chiari Malformation ,[object Object],[object Object]

Chiari Malformation ,[object Object],[object Object],[object Object]

Classification of Chiari Malformation ,[object Object],[object Object],[object Object],[object Object]

Type I ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Signs of Chiari I malformation ,[object Object],[object Object],[object Object]

Type II ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Type III ,[object Object],[object Object],[object Object]

Type IV ,[object Object],[object Object]

Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Posterior Fossa Decompression ,[object Object],[object Object],[object Object],[object Object]

Posterior Fossa Decompression ,[object Object],[object Object],[object Object]

Teo C, Parker EC, Aureli S, et al: The Chiari II Malformation: a surgical series. Pediatr Neurosurg 27: 223–229, 1997 ,[object Object],[object Object]

Posterior Fossa Decompression ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Position of Surgery : suboccipital approaches ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Incision ,[object Object],[object Object],[object Object]

Craniotomy or craneictomy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Dura Opening ,[object Object],[object Object],[object Object],[object Object]

Decompression : Resection of arachnoid adhesions ,[object Object]

Removal of inferior tonsils ,[object Object],[object Object]

Opening of the obex ,[object Object],[object Object],*Gardner WJ: Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J Neurol Neurosurg Psychiatry 28: 247–259, 1965

Opening of the obex ,[object Object],[object Object]

Syrinx decompression ,[object Object],[object Object],[object Object],[object Object],1Feldstein NA, Choudhri TF: Management of Chiari I malformations with holocord syringohydromyelia. Pediatr Neurosurg 31: 143–149, 1999 2Munshi I, Frim D, Stine-Reyes R, et al: Effects of posterior fossa decompression with and without duraplasty on Chiari malformation-associated hydromyelia. Neurosurgery 46: 1384–1390, 2000

Dura Closure of the Posterior Fossa ,[object Object],[object Object]

Closure of the craniotomy ,[object Object]

Fascial and skin closure ,[object Object],[object Object]

Position of Surgery : CSF Diversion Procedures ,[object Object],[object Object]

Early Postoperative Care ,[object Object],[object Object],[object Object],[object Object]

Late Postoperative Care ,[object Object],[object Object]

Complications Related to Conservative Surgery (Persistent Compression) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Recurrent symptoms post-operation ,[object Object],[object Object],[object Object],[object Object]

Complications of Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object]

Outcome and Follow-up ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Outcome and Follow-up ,[object Object],[object Object],[object Object],[object Object]

Algorithm For Symptomatic Chiari I Malformation

Algorithm For Asymptomatic Chiari I Malformation

Algorithm For Symptomatic Chiari II Malformation

Algorithm For Asymptomatic Chiari II Malformation

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