Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Patients With Chiari Malformation: Symptoms

Eric M. Jackson*, Sarah Jernigan, Jeffrey S. Raskin, Laurie L. Ackerman, Libby Kosnik Infinger, Cormac O. Maher, Toba Niazi, Jogi V. Pattisapu, Rabia Qaiser, Carolyn Quinsey, Brandon G. Rocque, Howard Silberstein, Shobhan Vachhrajani, David F. Bauer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Chiari I malformation (CIM) is characterized by descent of the cerebellar tonsils through the foramen magnum, potentially causing symptoms from compression or obstruction of the flow of cerebrospinal fluid. Diagnosis and treatment of CIM is varied, and guidelines produced through systematic review may be helpful for clinicians. OBJECTIVE: To perform a systematic review of the medical literature to answer specific questions on the diagnosis and treatment of CIM. METHODS: PubMed and Embase were queried between 1946 and January 23, 2021, using the search strategies provided in Appendix I of the full guidelines. RESULTS: The literature search yielded 430 abstracts, of which 79 were selected for full-text review, 44 were then rejected for not meeting the inclusion criteria or for being off-topic, and 35 were included in this systematic review. CONCLUSION: Four Grade C recommendations were made based on Class III evidence, and 1 question had insufficient evidence. The full guidelines can be seen online at https://www.cns.org/guidelines/browse-guidelines-detail/2-symptoms.

Original languageEnglish (US)
Pages (from-to)727-730
Number of pages4
JournalNeurosurgery
Volume93
Issue number4
DOIs
StatePublished - Oct 1 2023

Keywords

  • Activity restriction
  • Chiari I malformation
  • Guidelines
  • Screening
  • Symptoms
  • Systematic review
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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