Pediatric Extradural Chiari Decompression

This video summarizes a dural splitting craniocervical decompression procedure for Chiari I without syringomyelia. The goal of surgery for Chiari 1 malformation is to restore normal cerebral spinal fluid dynamics at the craniocervical junction. Traditionally, shrinkage or even resection of the cerebellar tonsils has been advocated. More recently, simple duraplasty without manipulation of the intradural contents or even extradural decompression have been undertaken. A dural splitting decompression procedure in a 17-year-old male who presented with medically refractory, unremitting and progressive suboccipital headaches is described.