The Complex Chiari

The complex has been described as Chiari that also involves the brainstem being herniated but in the absence of the other Chiari 2 features (myelomeningocele). 

 

Other features reported in Complex Chiari are:

 

- Retroflexed Odontoid/Medullary Kink

- Abnormal Clivoaxial angle

- Basilar Invagination

 

The literature currently supports that additional treatment beyond the standard Chiari Decompression Surgery is required. This may include occipital-cervical fusion and/or transoral odontoidectomy.

 

See our page for craniocervical instability. However, this is still controversial with no consensus between doctors. 

 

 

However, this presentation of a chiari type is still fairly new and still gaining support worldwide. Some doctors believe that with the improvements in MRI's that this is not a new type of chiari, but just an expected variation of Chiari Type 1. 

 

References:

Doug Brockmeyer Neurol Sci 32 (S345-347) 2011

Robert Bollo J NSGY Ped 10(2): 134-141, 2012

 

 

 

 

Complex CHiari
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