Though there is no cure for Chiari malformation, treatment through surgery has proven to be an effective means of managing the symptoms. A posterior fossa decompression is the surgical procedure performed to remove the bone at the back of the skull and spine.

In children who are not symptomatic but show signs of worsening cerebellar herniation, development or progression of syringomyelia or early hydrocephalus, we suggest a strong consideration for surgical treatment. In children that are symptomatic from a Chiari, we recommend surgical treatment.

Surgery for Chiari Malformations Surgery for Chiari Malformations Not everyone with a Chiari malformation requires surgery, but when a patient’s individual circumstances warrant it, a neurosurgeon may recommend “decompression” surgery (known as a “decompressive suboccipital craniectomy and cervical laminectomy”).

Chiari decompression surgery removes bone at the back of the skull to widen the foramen magnum and create space for the brain. The dura overlying the herniated tonsils is opened and a patch is sewn to expand the space, similar to letting out the waistband on a pair of pants.

Chiari malformation occurs when the brain pushes down through the hole in the base of the skull called the foramen magnum. This can cause pressure on the back of the brain (cerebellum) and/or the brain stem.

However, all too often these days, patients get operated on for Chiari 0 without a frank lower brain herniation, which is the focus of this blog. First, Chiari 0, or Cerebellar Tonsillar Ectopia (CTE), is when the back of the brain (cerebellum) isn’t really herniating down through the bottom hole in the skull.

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