[Chiari I malformation: postsurgical evolution after 2 years. Report of ten cases]. / Malformación de Chiari tipo 1: evolución postoperatoria a dos años. Análisis de 10 casos.

UNLABELLED: OBJECTIVE To describe the clinical and radiological evolution of ten patients with Chiari I malformation (CIM), treated surgically. METHOD: Ten patients with Chiari I malformation underwent suboccipital craniectomy, laminectomy of C1 and dural patch grafting. All of them were followed for at least two years. A magnetic resonance imaging was performed 6 months after surgery. Clinical preoperative evolution and time of installation, results of MRI and clinical postoperative evolution were correlated. RESULTS: In postoperative clinical evolution, we noted an important improvement in sensitive function, decrease of the syringohydromielia and partial improvement of cerebellar functions. Improvement of the motor alteration was less marked. During the two years after treatment the muscular atrophy did not change. CONCLUSIONS: Chiari I malformation is a congenital disease with many clinical manifestations which usually increase with time. A suitable diagnostic studies as well as an appropriate treatment are needed to improve the neurological results.

Malformación de Chiari tipo I: evolución postoperatoria a dos años. Análisis de 10 casos / Chiari I malformation: postsurgical evolution after 2 years. Report of ten cases

Objetivo. Describir la evolución de 10 pacientes con Malformación de Chiari tipo I (MCI), desde el punto de vista clínico y de imagen mediante resonancia magnética (RM). Método. A 10 pacientes con Malformación de Chiari se les realizó craniectomía suboccipital media, resección de arco posterior de C1 y plastia dural. A todos se les hizo un seguimiento clínico de dos años, y se hizo evaluación mediante RM a los seis meses del postoperatorio. Se correlaciona el tiempo de evolución preoperatoria, hallazgos de imagen mediante RM y la evolución clínica postoperatoria. Resultados. La evolución clínica postoperatoria mostró una mejoría importante en cuanto a función sensitiva, correlacionándose con la involución de la siringohidromielia que acompañaba a esos casos, mejoría parcial de sus funciones cerebelosas y, en menor grado, mejoría de la alteración motora. Las manifestaciones de atrofia muscular no tuvieron modificaciones en el seguimiento a dos años. Conclusiones. La MCI es una enfermedad congénita con múltiples manifestaciones clínicas que se van agravando conforme pasa el tiempo. Un diagnóstico oportuno y un tratamiento adecuado son indispensables para obtener los mejores resultado posibles desde el punto de vista neurológico

Objective To describe the clinical and radiological evolution of ten patients with Chiari I malformation (CIM), treated surgically. Method. Ten patients with Chiari I malformation underwent suboccipital craniectomy, laminectomy of C1 and dural patch grafting. All of them were followed for at least two years. A magnetic resonance imaging was performed 6 months after surgery. Clinical preoperative evolution and time of installation, results of MRI and clinical postoperative evolution were correlated. Results. In postoperative clinical evolution, we noted an important improvement in sensitive function, decrease of the syringohydromielia and partial improvement of cerebellar functions. Improvement of the motor alteration was less marked. During the two years after treatment the muscular atrophy did not change. Conclusions. Chiari I malformation is a congenital disease with many clinical manifestations which usually increase with time. A suitable diagnostic studies as well as an appropriate treatment are needed to improve the neurological results