Endoscopic third ventriculostomy in the management of Chiari I malformation and syringomyelia associated with hydrocephalus

Background: Chiari malformation with syringomyelia is conventionally managed with foramen magnum decompression and duroplasty. In presence of hydrocephalus, a ventriculoperitoneal shunt insertion has been the initial preferred mode of treatment. Methods: Two patients of Chiari I malformation with syringomyelia who had associated hydrocephalus were initially treated with endoscopic third ventriculostomy (ETV). Results: At follow up, both the patients symptomatically improved. Repeat MRI studies revealed collapse of the syrinx cavity and reduction of the Chiari malformation. Conclusions: Chiari malformation and syrinx associated with hydrocephalus may be effectively managed with endoscopic third ventriculostomy.