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.