Abstract
<h3>Objective:</h3> We aim to conduct this retrospective study to compare surgery and conservative treatment’s demographics, clinical presentations, and interventions for CM-1 patients in a tertiary hospital in Jordan. <h3>Background:</h3> Chiari malformation type 1 (CM-1) is a congenital anomaly associated with herniation of tonsillar pillars due to abnormality in hindbrain. Standard practice in treatment of (CM-1) is surgical decompression or conservative observation. <h3>Design/Methods:</h3> We reviewed our hospital’s patients’ clinical records, Brain MRI, and surgical assessment notes for CM-1 patients who presented to our hospital for the period between 2000 to 2022. <h3>Results:</h3> We identified 37 patients with (mean age) of (26.5 +/−19.77) years old and a female predominance n=21 (56.75%). Most patients were incidentally diagnosed or presented without symptoms n=22 (59.45%). Out of the 37 patients identified n=7 (18.9%) underwent surgery while n=30 (81.1%) were treated conservatively. Patients who underwent surgery were older in age compared to those who did not with a (mean age +/− S.D.) of (33.00 years +/−16.5) and (25.03 +/−20.40), respectively (p=0.08). Surgery was associated with worsening of symptoms compared to observation 57.14% vs 13.33% (p=0.01). Females were as likely to undergo surgery compared to males 19.04% vs 18.75% (p=0.98). Headache was the initial presentation in n=15 (40.50%) of the patients, other common presentations include: cranial nerve deficits n=20 (54.05%), neck and back pain in n=8 (21.62%), and gait abnormalities n=4 (10.81%). <h3>Conclusions:</h3> Chiari malformation type 1 is a medical condition with a wide array of clinical presentations that is hard to diagnose. Optimum treatment for CM-1 and its association with symptoms alleviation needs further investigation. <b>Disclosure:</b> Mr. Al-Zamer has nothing to disclose. Dr. Aburahma has nothing to disclose. Dr. Khasawneh has nothing to disclose. Dr. Hazaimeh has nothing to disclose. Dr. Jbarah has nothing to disclose.
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