{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T13:37:37Z","timestamp":1773063457781,"version":"3.50.1"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Suboccipital decompression is a common procedure for patients with Chiari malformation Type I (CMI). Published studies have reported complication rates ranging from 3% to 40%, with pseudomeningocele being one of the most common complications. To date, there are no studies assessing the effect of this complication on long-term outcome. Therefore, the authors set out to assess the effect of symptomatic pseudomeningocele on patient outcomes following suboccipital decompression for CM-I.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The study comprised 50 adult patients with CM-I who underwent suboccipital craniectomy and C-1 laminectomy with or without duraplasty. Clinical presentation, radiological studies, operative variables, and complications were assessed for each case. Baseline and 1-year postoperative patient-reported outcomes were assessed to determine improvement in pain, disability, and quality of life. The extent of improvement was compared for patients with and without development of a postoperative symptomatic pseudomeningocele.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A symptomatic pseudomeningocele developed postoperatively in 9 patients (18%). There was no difference with regard to clinical, radiological, or operative variables for patients with or without a postoperative pseudomeningocele. Patients without a pseudomeningocele had significant improvement in all 9 patient-reported outcome measures assessed. On the other hand, patients with pseudomeningocele only had significant improvement in headache (as measured on the Numeric Rating Scale) and headache-related disability (as measured on the Headache Disability Index) but no improvement in quality of life. Twenty-nine (71%) of 41 patients without a pseudomeningocele reported improvement in health status postoperatively compared with only 3 (33%) of 9 patients with a postoperative pseudomeningocele (p = 0.05).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Surgical management of CM-I in adults provides significant and sustained improvement in pain, disability, general health, and quality of life. Development of a postoperative symptomatic pseudomeningocele has lingering effects at 1 year, and it significantly diminishes the overall benefit of suboccipital decompression for CM-related symptoms. Further research is needed to accurately predict which patients may benefit from decompression alone without duraplasty.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.8.jns122106","type":"journal-article","created":{"date-parts":[[2013,9,6]],"date-time":"2013-09-06T13:54:05Z","timestamp":1378475645000},"page":"1159-1165","source":"Crossref","is-referenced-by-count":21,"title":["Effect of symptomatic pseudomeningocele on improvement in pain, disability, and quality of life following suboccipital decompression for adult Chiari malformation Type I"],"prefix":"10.3171","volume":"119","author":[{"given":"Scott L.","family":"Parker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saniya S.","family":"Godil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen K.","family":"Mendenhall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noel B.","family":"Tulipan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"McGirt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"b1-jns122106","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Surgical treatment of Chiari I malformation: indications and approaches","volume":"11","author":"Alden","year":"2001"},{"issue":"1","key":"b2-jns122106","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Treatment of Chiari I malformation in patients with and without syringomyelia: a consecutive series of 66 cases","volume":"11","author":"Alzate","year":"2001"},{"key":"b3-jns122106","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1227\/01.NEU.0000368391.79314.6F","article-title":"Validation of a translated version of the modified Japanese orthopaedic association score to assess outcomes in cervical spondylotic myelopathy: an approach to globalize outcomes assessment tools","volume":"66","author":"Bartels","year":"2010"},{"issue":"1","key":"b4-jns122106","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Definition of the adult Chiari malformation: a brief historical overview","volume":"11","author":"Bejjani","year":"2001"},{"key":"b5-jns122106","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1007\/s00381-002-0590-3","article-title":"Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation","volume":"18","author":"Bosma","year":"2002"},{"issue":"3 Suppl","key":"b6-jns122106","series-title":"J Neurosurg","first-page":"187","article-title":"The role of limited posterior fossa craniectomy in the surgical treatment of Chiari malformation Type I: experience with a pediatric series","volume":"106","author":"Caldarelli","year":"2007"},{"key":"b7-jns122106","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2479","DOI":"10.1097\/00007632-199512000-00001","article-title":"\u201cConservative\u201d cranio-cervical decompression in the treatment of syringomyelia-Chiari I complex\u201d. 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