TreatmentsforChiari I malformations

Treatment for Chiari I malformation depends on whether you have any symptoms and how severe they are. You might not need any treatment if you don't have any symptoms.

Painkillers can help relieve any headaches and neck pain.

If your headaches are severe or you have problems caused by the pressure on your spinal cord (such as movement difficulties), surgery may be recommended.


The main operation for Chiari malformation is called decompression surgery.

Undergeneral anaesthetic a cut is made at the back of your head and the surgeon removes a small piece of bone from the base of your skull. They may also remove a small piece of bone from the top of your spine.

This will help reduce the pressure on your brain and allow the fluid in and around your brain and spinal cord to flow normally.Read an NHS leaflet about decompression for Chiari malformation (PDF, 111kb).

Other procedures that maybe necessaryinclude:

  • Endoscopic third ventriculostomy (ETV) a small hole is made in the wall of one of the cavities of the brain, releasing trapped fluid. Seetreating hydrocephalus for more information.
  • Ventriculoperitoneal shunting a small hole is drilled into the skull and a thin tube called a catheter is passed into the brain cavity to drain trapped fluid and relieve the pressure.Seetreating hydrocephalus for more information.
  • Untethering some children with a type 1 Chiari malformation have a tethered spinal cord, which means it is abnormally attached within the spine. Untethering involves separating the spinal cord and releasing tension in the spine.Read an NHS leaflet on tethered spinal cord (PDF, 193kb).
  • Spinal fixation some people with Chiari I will have a hypermobility syndrome, such as Ehlers-Danlos syndrome, and may require surgery to stabilise their spine.

The aim of surgery is tostop existing symptoms getting any worse. Some people also experience an improvement in their symptoms, particularly their headaches.

However, surgery sometimes results in no improvement or symptoms getting worse.There's also asmall risk of serious complications, such as paralysis ora stroke.

Talk to your surgeon about the different surgical options and what the benefits and risks of each are.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 21 Dec 2018