Chiari Malformation can cause a variety of symptoms including headaches, numbness, and weakness. This patient had a type 1 chiari malformation and was having bad headaches especially when coughing and sneezing. The incision is made in the back of the head. We removed the back of the skull and the top part of the C1 arch. The dura is opened followed by the arachnoid. The cerebral tonsils are mobilized and coagulated back. At the end we are able to look into the fourth ventricle to ensure spinal fluid can freely flow. A diesel patch is then sewn in and the wound is closed.