ArticleSurgical Management of Chiari MalformationSteinmetz, Michael P.*; Benzel, Edward C.†Author Information *Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio; and †Director of Spinal Disorders, Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio Corresponding author: Michael P. Steinmetz, MD, Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH. Neurosurgery Quarterly: June 2003 - Volume 13 - Issue 2 - p 105-112 Buy Abstract The Chiari malformation is frequently encountered by neurosurgeons. The pathogenesis and natural history of the malformation is unknown. Patients often present with symptoms related to brainstem compression, hydrocephalus, syringomyelia, and/or cerebellar compression. Some patients present vague symptoms or are asymptomatic. With the increased sensitivity of modern imaging, asymptomatic patients are seen more frequently. Decisions for the surgical management of Chiari malformations are based upon clinical findings and correlative imaging findings. Decompression of the craniovertebral junction in this patient population result in the majority showing improvement or stabilized symptoms. © 2003 Lippincott Williams & Wilkins, Inc.