A multidisciplinary team at Weill Cornell Medicine, spanning neurosurgery, neuropsychology and clinical research, published two complementary reviews that together provide a comprehensive look at how Chiari malformation type I (CM-I) affects cognition across patients’ lifespans. The work was led by neurosurgery fellow Dr. Mohammed A. Fouda in collaboration with Drs. Jeffrey P. Greenfield, H. Allison Bender and Amanda Sacks-Zimmerman.
Pediatric Review
The pediatric review, published in Child’s Nervous System, evaluates how CM-I may affect working memory, executive function, attention and language in children. Parents frequently reported executive dysfunction, particularly difficulties with planning and organization. Evidence on postoperative cognitive improvement remains inconsistent, reinforcing the need for standardized testing and long-term follow-up.
Adult Review
The adult systematic review in Neurosurgical Review examined 19 studies with 1,226 adult patients. Cognitive impairments were common, especially in processing speed, visuospatial skills, attention and executive function. Advanced imaging revealed widespread microstructural abnormalities that may contribute to these deficits. Although decompression surgery improves anatomical and symptomatic outcomes, cognitive gains varied across studies.
A Lifespan Perspective
Together, these publications highlight the value of coordinated research across specialties and age groups to better understand the neurocognitive impact of CM-I . They also emphasize the need for consistent, multimodal evaluation from diagnosis through adulthood.
Read the full studies:
- Adult Review (Neurosurgical Review): https://link.springer.com/article/10.1007/s10143-025-03967-3
- Pediatric Review (Child’s Nervous System): https://link.springer.com/article/10.1007/s00381-025-07055-1#auth-Mohammed_A_-Fouda-Aff1