Background Data: Chiari malformation type-I (CM-I) is a challenging subject to
wrap our hands around table. Chiari symptoms often range from, unexplained,
and/or occipital Valsalva type headache, chronic fatigue syndrome, to
lower cranial nerve abnormalities, or brain stem compression, till severe
neurological insult which augmented by syringomyelia, or syringobulbia.
Exact diagnostic and prognostic tools carry a great controversy which ranged
from simple MRI study to MR imaging–based CSF velocity measurements,
morphological, dynamic craniocervical junction assessments, subarachnoid
pressure recordings, and compliance calculations were compared before
and after surgical treatment.
Purpose: This study aimed to estimate the efficacy and safely of duraplasty
in CM-I patients associated with syringomyelia.
Study Design: A retrospective descriptive clinical case study.
Patients and Methods: The study was conducted on 23 consecutive adults
patients with CM-I associated with syringomyelia. They underwent surgical
treatments at Sohag University Hospital from February 2012 to May 2015.
Results: The current study was applied to 23 patients; 10 males (43.5%) and
13 females (56.5%), aged 18-64 with a mean age of 41 years. The duration
of symptoms before presentation varied from 1 month to 20 years. Clinical
outcome was classified according to Glasgow outcome scale, 21 patients
(91.3%) were graded V, 2 patients (8.7%) were grade IV, and no patient graded
I. Radiologically MRI craniocervical junction suggested that decompression
of the posterior fossa was achieved in all patients. Post-operative reports

showed that no deterioration occurred in any of our patients. Improvement occurred and increased
gradually on post-operative period.
Conclusion: Craniocervical decompression with duraplasty is effective in treating patients with Chiari
Malformation type-I with syringomyelia. Both clinical and radiologic improvement was documented
on the follow up period.