MODERN NEUROSURGICAL STRATEGIES AND OUTCOMES IN THE TREATMENT OF CHIARI MALFORMATION TYPE I AND ASSOCIATED SYRINGOMYELIA

Abstract

Chiari malformation type I (CM-I) and syringomyelia represent complex congenital anomalies of the craniovertebral junction that can lead to significant neurological impairment. Surgical treatment is indicated only for patients with progressive clinical symptoms or deteriorating quality of life. The primary goals of neurosurgical intervention include restoration of cerebrospinal fluid (CSF) circulation, decompression of the posterior cranial fossa, and prevention of brainstem compression. This article reviews modern approaches, including various techniques of suboccipital craniectomy, C1 laminectomy, dura mater plasty, and management of associated hydrocephalus. Comparative analysis of surgical outcomes demonstrates that adequate CSF restoration significantly improves long-term results, while complications such as CSF leakage, aseptic meningitis, and craniovertebral instability remain relevant. The study emphasizes the importance of individualized selection of decompression techniques and intraoperative CSF dynamics monitoring for optimal prognosis.