Foramen Magnum Decompression for Chiari Malformation
Information about Surgery for Chiari Malformation
Foramen magnum decompression, or posterior fossa craniectomy, is the surgery procedure used to treat Chiari malformation. Chiari malformation is a benign abnormality that results in a part of the brain extending into the upper spinal canal. During the procedure, small sections of bone are removed from the rear of the skull and spine to create more space for the protruding brain tissue. Dr Oehme routinely performs a duraplasty during this surgery to further increase the space for the brain and increase the chances of improving symptoms.
For more information about foramen magnum decompression for Chiari malformation watch the video below.
Risks of Foramen Magnum Decompression
Most operations for Chiari Malformation can be performed safely without any complications. However, like any surgical procedure there are risks associated with both the anaesthetic and the procedure itself.
Risks of Anaesthesia
Risks of anaesthesia will be discussed with you by your anaesthetist prior to surgery. It is important that you inform us of your correct age and any past medical problems, as this can influence the risk of anaesthesia. Risks include:
- Heart problems, such as heart attack (AMI) or arrhythmia
- Lung problems, such as infection (pneumonia) or blood clots
- Urinary tract infection
- Deep Venous Thrombosis (DVT)
- Eye or visual problems
- Pressure wounds
- Small risk of significant life-threatening event
General Risks of Craniotomy
Although surgery for Chiari is generally safe, there are some risks whenever performing a craniotomy. These include:
- Infection 1-2%
- Seizures which can require taking medication. Rarely this can lead to epilepsy requiring longterm medication.
- Bleeding. This can occur at the time of surgery and may necessitate a blood transfusion. It can also occur at some time after surgery. The bleeding may be present in the brain or adjacent to it. Sometimes another operation is required to drain the bloodclot and stop the bleeding.
- Brain fluid leak (CSF leak)
- Small risk of significant neurological injury causing paralysis, coma or death.
Specific Risks of Foramen Magnum Decompression
The specific risks will be discussed in detail prior to your surgery but may include:
- Damage nerves in the brain (cranial nerves) resulting in facial numbness, weakness of the face, loss of vision or double vision, difficulty swallowing or coughing, tongue paralysis respiratory and cardiac problems.
- Weakness or numbness in the limbs
- Balance or gait problems
- Paralysis (stroke like symptoms)
- Spinal cord or brainstem injury
- Intracranial arterial injury
- Visual problems
- CSF leak and collection under the wound
- Spinal instability
- Persistant symptoms
- Headaches no better
- Recurrence of symptoms
- Cerebellar slump