Document Detail

Treatment and management of the Chiari II malformation: an evidence-based review of the literature.
MedLine Citation:
PMID:  15133704     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Multiple surgical strategies exist for the management of the symptomatic Chiari II malformation. To date, no comprehensive analysis of this medical literature in an attempt to seek out standards or guidelines has been performed, thus serving as the impetus for this present review. METHODS: A computerized search of the database of the National Library of Medicine was performed on the English-language medical literature between 1966 and 2003. Terms searched for included hindbrain hernia, Chiari II, Arnold-Chiari, surgery, decompression, syringomyelia, and CSF shunts. All literature found was reviewed with associated references from these sources. Each piece of literature reviewed was scrutinized and guidelines developed utilizing the methodology used by the Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injuries. RESULTS: All data reviewed were deemed to be Class III in nature. No standards or guidelines could be established from the available literature. There is significant debate and variable results in the current neurosurgical literature regarding the evaluation of shunt function vs. Chiari II decompression in patients with symptomatic hindbrain herniation. CONCLUSIONS: Multi-institutional prospective randomized trials are needed before any conclusions can be drawn regarding symptomatic Chiari II and its treatment paradigm. Until this time, clinical practice will be based on individual surgeons' experience, training, and personal beliefs.
R Shane Tubbs; W Jerry Oakes
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Publication Detail:
Type:  Journal Article; Review     Date:  2004-05-07
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  20     ISSN:  0256-7040     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-15     Completed Date:  2004-08-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  375-81     Citation Subset:  IM    
Department of Cell Biology, University of Alabama at Birmingham, Children's Hospital, 1600 7th Avenue South ACC 400, Birmingham, AL 35233, USA.
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MeSH Terms
Arnold-Chiari Malformation / therapy*
Databases as Topic
Evidence-Based Medicine
National Library of Medicine (U.S.) / statistics & numerical data
Practice Guidelines as Topic / standards
Review Literature as Topic*
Treatment Outcome
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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