Surgical management of hydrosyringomyelia related with Chiari I malformation

A retrospective study was conducted on 48 consecutive patients with hydrosyringomyelia. Fortyseven of them had Chiari I malformation and one had stenosis of foramen magnum. The most common symptom was numbness in arms and the most common physical finding was dissociated sensory loss. The patients were operated by syringosubarachnoid shunt (12 cases), syringoperitoneal shunt (3 cases), posterior fossa decompression and syringosubarachnoid shunt (17 cases), posterior fossa decompression alone (13 cases), and ventriculoperitoneal shunting alone (3 cases). Fifteen patients had had previous surgery for their illness. The majority of previous surgery was found to be syringosubarachnoid shunt or syringoperitoneal shunt. Our results and our literature review suggest that a posterior fossa decompression is the first option for the surgical treatment of hydrosyringomyelia related with Chiari I malformation.