Document Detail

Relevance of surgical strategies for the management of pediatric Chiari type I malformation.
MedLine Citation:
PMID:  17252266     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In face of continuing controversy to the optimal treatment of Chiari type I malformation, the authors analyzed three different surgical strategies. MATERIALS AND METHODS: Sixty patients (30 boys and 30 girls, mean age 8.2 years) presented with clinical Chiari malformation. Additional syringomyelia was present in 24 children, whereas cine flow studies showed no flow in the craniocervical junction in 48 children. All patients underwent a limited occipital craniectomy; a duraplasty was performed in 21 cases; and additional tonsillar reduction was performed in 19 cases. Clinical improvement was seen in 24 patients who underwent posterior decompression with or without duraplasty. In the tonsillar group, clinical improvement was evident in 18 patients. CONCLUSIONS: Duraplasty and tonsillar reduction were equally effective but significantly better than bone decompression alone. Among patients with syringomyelia, tonsillar reduction was associated with a significantly better outcome. Postoperative flow studies improved in 39 patients but did not correlate to the clinical outcome.
Marcelo Galarza; Sandeep Sood; Steven Ham
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-01-25
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  23     ISSN:  0256-7040     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-09     Completed Date:  2007-10-30     Revised Date:  2008-05-02    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  691-6     Citation Subset:  IM    
Department of Neurosurgery, Children's Hospital of Turin, Turin, Italy.
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MeSH Terms
Arnold-Chiari Malformation / complications,  surgery*
Cerebellum / surgery
Child, Preschool
Craniotomy / methods
Decompression, Surgical / methods*
Dura Mater / surgery
Neurosurgical Procedures / methods*
Postoperative Complications / prevention & control*
Retrospective Studies
Syringomyelia / complications,  surgery*
Treatment Outcome
Comment In:
Childs Nerv Syst. 2007 Jul;23(7):725-6; author reply 727   [PMID:  17450364 ]
Childs Nerv Syst. 2007 Dec;23(12):1353; author reply 1354   [PMID:  17882437 ]

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