Postcraniotomy Pain and Chiari Malformation Pain

The clinical syndrome associated with Chiari malformation type 1 (CM1) affects all ages, newborns through elderly. Boys and girls are affected equally; adult women are affected three times more than men. The most common form of Chiari malformation, CM1, is often asymptomatic, but one common symptom of CM1 is occipital headache triggered by Valsalva maneuvers. A syrinx, present in many patients, causes neurologic deficits at the level of the syrinx or below. There are medical and surgical management options to treat the pain syndromes associated with CM1. For patients who are resistant to medical and interventional therapy after surgical decompression, few efficacious treatments are available to relieve chronic postoperative, postcraniotomy pain.