Chiari malformation complicated by postoperative hydrocephalus after cervical decompression:a case report
CHEN Xiao-chen
WANG Jia
SUN Dong-dong
LIU Wei
Abstract：Chiari malformation(also known as Arnold-Chiari malformation),most commonly type I,is frequently associated with syringomyelia.However,concurrent hydrocephalus is relatively uncommon,and hydrocephalus secondary to cerebrospinal fluid(CSF)leakage after cervical spinal canal decompression surgery represents an exceedingly rare complication.We present the case of a 63-year-old female with Chiari malformation type I and cervical spinal stenosis who underwent posterior cervical spinal canal decompression.Postoperatively,she developed cervical subcutaneous effusion and hydrocephalus,which were attributed to CSF leakage from intraoperative dural injury.Consequently,a second-stage surgery—posterior fossa decompression,occipitocervical fusion,and CSF leak repair—was performed.Intraoperative exploration revealed a 2-mm dural defect at the C6 vertebral level with persistent CSF leakage,successfully repaired using an autologous fascial graft.One month after the surgery,a follow-up head CT scan revealed a significant dilation of the ventricular system.Subsequently,a ventriculoperitoneal shunt procedure was performed.A head CT scan 10 days after the shunt showed normal ventricular morphology.This case highlights the critical importance of meticulous dural protection during decompressive surgery for Chiari malformation with cervical stenosis and underscores the necessity for vigilant postoperative monitoring of CSF dynamics to mitigate such complications.
Keywords：Chiari malformationCervical spinal canal stenosisPosterior fossa decompressionHydrocephalusCerebrospinal fluid leakage
Publication Date：2025-03-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 190-192 )