Can chiari malformations come back after surgery?

Yes: Chiari malformation decompression surgery is not a 100% effective and some patients will have recurrent symptoms due to scarring at the surgical sight or the development of new problems such as cord syrinx

Symptoms not Chiari: The chiari type 1 malformation involves a descent of a structure called the cerebellar tonsil below a bony edge called the foramen magnum, large hole. These tonsils generally are not removed with chiari surgery but more space is made around them with removal of the overlying bone. There are different ways to patch this area to minimize scarring. New headaches after surgery need evaluation.