Arnold-Chiari and tethered cord syndrome: an update

Key words: Arnold-Chiari syndrome, Tethered cord syndrome, Filum terminalis section

“Chiari malformations” are a heterogeneous group of disorders defined by anatomic anomalies of the cerebellum, brainstem and craniovertebral junction with downward displacement of the cerebellum, either alone or together with the lower medulla, into the spinal canal. The diagnosis of Chiari malformation is based upon neuroanatomy: signs and symptoms may be absent, and when present, they can vary in a wide spectrum. Indication for surgical intervention is controversial, as well as the surgical procedure to apply. The paper presents an emblematic case both for the difficulty for physicians in getting the right diagnosis and the trouble for families to choose the right management.