[Basilar impression and malformation of Arnold-Chiari. Postoperative complications in 126 cases (author's transl)]. / Postoperative Komplikationen bei 126 Fällen basilärer Impression und Arnold-Chiarischer Missbildung.

Within a period of ten years we operated on 126 cases of basilar impression and/or Arnold-Chiari malformation. Two surgical techniques were employed for decompression of the posterior fossa. In the group I (64 cases) the operation consisted of craniectomy and the dura mater was left open and was fixed to the lateral musculature. The technique of the group II (62 cases) consisted in endotracheal intubation without flexion of the head, position of the head without anterior flexion during the operation and plastic closure of the dura. The dural graft was employed to create more space at the craniocervical joint, to avoid cerebrospinal fluid fistula and to restore the integrity of the dura as a protection for the nervous structures of the posterior fossa. The frequency of postoperative complications and mortality observed in group II was definitely less than in the group I.

[Postoperative complications in 139 cases of basilar impression and/or Arnold-Chiari deformity]. / Complicações pos-operatórias em 139 casos de impressão basilar e/ou malformação de Arnold-Chiari.

The many kinds of complication that have been observed following operations of basilar impression and/or malformation of Arnold-Chiari are analysed. Two surgical techniques were adopted in the treatment of the patients. In the first 64 cases, the operation consisted in the craniectomy of the posterior fossa and high cervical laminectomy, while the dura-mater remained opened and saturated to the lateral musculature. Concerning the other 75 cases, it was made a plastic of the dura-mater of the posterior fossa and, in most of the cases, the patients were intubated with no retroflexion of the head and operated in sitting position without anterior flexion of the head. In the second group of patients, it was observed lesser occurrence of complications and death.

Complicacoes pos-operatorias em 139 casos de impressao basilar e/ou malformacao de Arnold-Chiari. / Postoperative complications in 139 cases of basilar impression and/or Arnold-Chiari deformity.

No presente trabalho, foram analisadas as complicacoes pos-operatorias observadas em 139 casos de impressao basilar e/ou malformacao de Arnold-Chiari. Os autores chamam a atencao para a menor ocorrencia de complicacoes e de mortalidade verificadas nos pacientes que foram submetidos a plastica da duramater da fossa posterior.

[The basilar impression and the Arnold-Chiari malformation. Techno-surgical considerations apropos of 13 cases]. / Impressão basilar e malformação de Arnold-Chiari. Considerações técnico-cirúrgicas a propósito de 13 casos.

The surgical technic for decompression of the posterior fossa in cases of basilar impression and malformation of Arnold-Chiari mainly based in (1) endotracheal intubation without any flexion of the head, (2) position of the head without anterior flexion during the surgery, (3) plastic of the posterior fossa with dura-mater of cadaver conserved in glicerina, was emploied in 13 patients. The plastic was made to create space at the craniocervical joint in order to avoid cerebrospinal fluid fistula and to restore the integrity of the dura. Infection was not observed.