ABSTRACT
Pain is the most common complaint of type I Chiari malformation in adults and can often precede significant clinical exam findings. Often, a radiographic diagnosis precedes any physical exam finding. The surgical management of Chiari I malformation is chiefly a decompressive operation, directed at the foramen magnum and upper cervical spine, where the underlying cerebellar tonsils are impacting the lower brainstem and cervical spine. Arguably, maintenance of a bloodless exposure and strict hemostasis will prevent bone dust and blood from entering the intradural space, which can be a source of aseptic chemical meningitis, and increased postoperative pain. Syringomyelia is encountered most commonly in adult patients and is a condition of symptomatic cord compression by intramedullary cyst formation and expansion. This disease process is highly complex and commonly encountered in the neurosurgical community. This patient population is young, and the families that accompany them are often apprehensive due to the looming possibility of an upcoming neurosurgical procedure.
