Conditions We Treat

Our neurosurgery team of highly qualified doctors including neuropsychologists, neurophysiologists, and other specialty surgeons treat Chiari malformations and related conditions:

Chiari Simple: tonsillar herniation with a small posterior fossa

Chiari Plus: Chiari malformation, Type I with comorbidity (another chronic condition or disease) such as

• Syringomyelia
• Connective tissue disorders
• Craniocervical instability
• Pseudotumor cerebri
• Tethered cord

Chiari Redux: failed CMI surgery

Advanced Chiari Malformation Treatments in the Long Island, New York Region

Recent advancements and continued research have led to a range of options when treating Chiari malformations. No one single technique works for everyone. The surgeon and patient need to work together to determine the best approach. Dr. Bolognese performs 200 CMI (Chiari Malformation, Type I) or CMI-related pathologies each year, including Posterior Fossa Decompressions and Posterior Fossa Revisions.

Simple Chiari Malformation Treatment

• Extradural techniques: cutting the bone alone
• Minimally invasive approaches: small incisions or the use of small ports to access and surgically treat the malformation
• MIST (minimally invasive subpial tonsillectomy): a small 2-cm incision is used to create more room and decompress the 11th cranial nerve, without the need for duralplasty. This incision is in the thickest part of the dura, so the risk of cerebrospinal fluid leakage is greatly reduced.

Surgical Management of Complex Chiari Malformations
The surgical approaches for treating Chiari that also involve cranial cervical instability or abnormal anatomy of the craniocervical junction are more complex: Posterior Fossa Decompression (PFD) and a Craniocervical Fusion (CCF) with Transoral Odontoidectomy, if necessary. The use of heftier screws in the occipital condyles reduces the need for 4-5 inches of clunky hardware attached to thin bone and instead is a 1.25 inch of stronger hardware attached to a much thicker bone.

Convenient Long Island, New York Locations

World-class Chiari treatment, close by. Staffed by physicians of multiple specialties, NSPC has developed to meet the needs of a wider patient population. Thanks to our locations throughout the greater tri-state area, more patients have access to comprehensive, collaborative quality care.

Chiari Malformations Educational Videos by Dr Paolo Bolognese

PART I: Discovery, Definition and Classification of Chiari Malformations
PART II: Modern Classification and Subclassification of Chiari Malformations
PART III: Trends & History of Surgery for Chiari Malformations
PART IV: Surgical Techniques Chiari Malformations

Our Chiari Malformation Team

Our Neurosurgeon

• Paolo A. Bolognese, M.D.