Chiari malformation in a restricted-resource setting and treatment challenges: Case report and literature review

Abstract

Abstract Background Chiari malformations encompass many abnormalities in the skull, primarily impacting the cerebellum and typically involving the back part of the skull. It is defined by the downward displacement of one or both cerebellar tonsils via the foramen magnum. The clinical manifestations are a result of impaired function in the brainstem and lower cranial nerves. Decompressive surgery, with or without duraplasty, is the preferred therapeutic option. However, it can be particularly difficult in low-resource settings due to a lack of technical facilities. Case presentation A 40-day-old infant was brought to our pediatric surgery unit with a large cystic mass located in her occipital area. The patient was administered a suitable antibiotic regimen in response to the respiratory illness and prepped for definitive treatment. She underwent tension-free decompressive repair with the preservation of both cerebellar tonsils without duraplasty for the purpose of preventing post-operative complications, mostly hydrocephalus. The surgical procedure and postoperative period were without any notable incidents. Conclusion Chiari malformation is a complex neurosurgical condition with varying levels of surgical outcome, depending on the extent of the problem. A specialized pediatric neurosurgical center and a controlled follow-up system are the essential components of better surgical results and enhancing the quality of life.