Estudio internacional sobre el manejo de la Malformacion de Chiari I y la Siringomielia / International survey about the management of Chiari and syringomyelia

RESUMEN

Objectives: An international survey has been carried out under the sponsorship of the ISPN Education Committee in order to clarify what were the clinical and surgical strategies that neurosurgeons currently use for the management of these clinical problems. Methods: A questionnaire was designed based on hypothetical case histories. 246 questionnaires were sent between October 2001 and March 2002 by e mail, post mail or fax to the ISPN members as well as to the members AANS Pediatric Section e-mail lis who wished to enter in the study. 76 responses to the survey (30,8 por ciento) were returned. For data analysis, responses were entered in a Microsoft Excel spreadsheet. Results: REspondents agreed to not operate asymptomatic Chiari I patients. IN asymptomatic patiens with Chiari I and syringomyelia surgical decisions depend on syrinx size. For suboccipital decompression the majority prefers to open the dura and close it with a patch graft. In cases of surgix progression respondents prefer to shunt it to the subarachnoid space. Conclusion: There is a consensus on treating conservatively asymptomatic patients with Chiari I malformation. Management is not uniform when there are minimal or doubtful symptoms and for asymptomatic patients with syringomelia, respondents recommend suboccipital decompression as the first treatment modality