Chiari Decompression Surgery

A Chiari decompression is a type of craniotomy designed to make additional space for the herniated cerebellum, relieve pressure on the brain, and restore the normal flow of cerebrospinal fluid (CSF) around the brain.

The cerebellum is the part of the brain located at the bottom section of the back of the head. Within that section of the brain, there are two small areas at the bottom called the cerebellar ‘tonsils’. With a Chiari malformation that requires surgery, the patient’s cerebellar tonsils descend into the spinal canal, which is also referred to as a herniation of the brain into the spinal canal.

Asymptomatic Chiari malformations do not require any treatment, where as malformations causing only headaches are initially treated with a pain control medication program. Surgery is done on patients that are experiencing extreme headaches or any other serious abnormal neurological findings.

The surgery begins with a incision made at the back of your head and extends down to the upper part of your neck. The muscles around your neck are elevated and a tiny amount of bone is removed from the base of your skull allowing the cerebellum more space and decompresses the brainstem. Often the herniation extends through the spinal canal formed by the first neck bone (C1), the posterior arch of the bone is also removed. The incision is then closed with staples.

You will be transferred to the recovery room immediately after surgery, which will monitor you closely, particularly in relation to your level of consciousness and important vital signs. You should expect to spend anywhere from 3-5 days at the hospital following this procedure.