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BACKGROUND Chiari 1 malformation is a structural abnormality of the hindbrain and posterior fossa characterised by herniation of the cerebellar tonsils through the foramen magnum. Although asymptomatic in some cases, hindbrain herniation may be associated with disruption of cerebrospinal fluid flow dynamics at the craniovertebral junction and syrinx formation leading to symptoms. Foramen magnum decompression with or without duraplasty is the most commonly performed surgical procedure in the management of this condition. Management of syr