Surgical Outcome of Adult Idiopathic Chiari Malformation Type 1
Journal of Korean Neurosurgical Society
;
: 512-517, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-34887
ABSTRACT
OBJECTIVE:
The pathophysiology of idiopathic Chiari malformation (CM) type 1 is disturbance of free cerebrospinal fluid (CSF) flow and restoration of normal CSF flow is the mainstay of treatment. Additional migration of the medulla oblongata in pediatric patients is referred to as CM type 1.5, but its significance in adult patients is unknown. This study is to compare surgical outcomes of adult idiopathic CM type 1.5 with that of type 1.METHODS:
Thirty-eight consecutive adult patients (M F=11 27; median, 33.5; range, 18–63) with syringomyelia due to idiopathic CM type 1 were reviewed. Migration of the medulla oblongata was noted in 13 patients. The modified McCormick scale (MMS) was used to evaluate functional status before and one year after surgery. All patients underwent foramen magnum decompression and duroplasty. Factors related to radiological success (≥50% decrease in the diameter of the syrinx) were investigated. The follow-up period was 72.7±55.6 months.RESULTS:
Preoperative functional status were MMS I in 11 patients and MMS II in 14 of CM type 1 and MMS I in 8 and II in 5 of CM type 1.5. Of patients with MMS II, 5/14 patients in group A and 3/5 patients in group B showed improvement and there was no case of deterioration. Radiological success was achieved in 32 (84%) patients and restoration of the cisterna magna (p=0.01; OR, 46.5) was the only significant factor.CONCLUSION:
Migration of the medulla oblongata did not make a difference in the surgical outcome when the cisterna magna was restored.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Aracnoide-Máter
/
Siringomielia
/
Rombencéfalo
/
Bulbo
/
Líquido Cefalorraquidiano
/
Seguimentos
/
Cisterna Magna
/
Descompressão
/
Forame Magno
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Adulto
/
Humanos
Idioma:
Inglês
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2016
Tipo de documento:
Artigo
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