Chiari Malformations

Chiari malformations are structural defects in the base of the skull and cerebellum. These conditions are characterized by the abnormal displacement of part of the cerebellum and brainstem through the foramen magnum into the upper spinal canal causing autonomic dysfunction, neurologic deficits, and hydrocephalus. Chiari malformations are classified into several types based on their severity and the parts of the brain affected by the herniation. In neonates, Chiari malformations are commonly associated with spina bifida and myelomeningocele. Anesthesia for surgical correction of Chiari malformations presents a unique set of challenges and demands that requires knowledge of both the neurophysiology of the condition and the surgical process.