Do you need surgery for subungual herniation of the cerebellar tonsils?

  Inferior herniation of the cerebellar tonsils is defined as a condition in which the cerebellar tonsils exceed the greater occipital foramen downward by more than 5 mm due to insufficient cranial cavity capacity.  The answer is no. Simple subungual hernia, without any clinical symptoms, does not require surgical treatment.  The indications for surgery include: 1. Severe lower herniation, with obvious brainstem symptoms or cerebellar symptoms.  2. The patient has a spinal cord cavity, and the cavity is gradually increasing in size on review.  3.The patient has a small spinal cord cavity, but there is obvious separation, segmental, and sensory impairment.  4. The lower herniation is accompanied by vertebral dentition instability and cricoaxial subluxation.