Conservative management for pediatric patients with chiari 1 anomaly: A retrospective study

Abstract Objective To better understand the natural history of non-surgical management of chiari 1 anomaly. Patients and Methods After obtaining approval of the institutional review board, medical records and radiological exams of patients treated for CM1 at our institution between the years 2010 and 2016 were reviewed. Twenty-nine patients total were included in our study. Results The average age of our patient population was 8.5 years old at the time of diagnosis. The average tonsillar herniation on first MRI was 9.4 mm (+/− 4.6) and the average tonsillar herniation on second MRI was 10.4 mm (+/− 4.8). The average follow up time of our sample of patients was 26 months. Of the 29 patients in our study 9 (31 %) had symptomatic presentation. Interestingly, four of our patients (13.8 %) presented with epilepsy. Conclusions Our findings support the previous work that nonoperative management is best in asymptomatic or mildly symptomatic chiari patients.