Modified reconstruction of the cistern magna for treatment of syringomyelia with Chiari malformation: clinical analysis of 35 cases / 南方医科大学学报
Journal of Southern Medical University
; (12): 284-288, 2009.
Article
Dans Zh
| WPRIM
| ID: wpr-339008
Responsable en Bibliothèque :
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To explore the surgical approaches, microsurgical techniques and therapeutic effect of modified cistern magna reconstruction for treating of syringomyelia with Chiari malformations.</p><p><b>METHODS</b>The clinical data of 35 patients with syringomyelia complicated by Chiari malformations were retrospectively reviewed, and the patients' chief complaints, presenting symptoms, neurological and radiographic findings, surgical approaches, outcomes, and complications were analyzed.</p><p><b>RESULTS</b>The radiographs revealed type I Chiari in 18 and type II Chiari malformations in these patients. Surgical treatment resulted in symptomatic improvements in 29 patients, and 6 patients showed no obvious changes in the symptoms after the surgery; 3 patients received subarachnoid shunting for syringomyelia. During the follow-up for a mean of 2 years, 32 patients showed obvious clinical improvement, and magnetic resonance imaging demonstrated complete spontaneous resolution of syringobulbia in 25 patients.</p><p><b>CONCLUSION</b>Modified cistern magna reconstruction relieves brainstem compression and restores the pulsatile flow of the cerebrospinal fluid at the cervicomedullary junction. Cerebellar tonsil reduction is performed chiefly by electric coagulation and cauterization combined with subpial resection, and the integrity of the pia mater should be maintained as much as possible to avoid potential adhesion and recurrence. The median foramens and Luschka of the fourth ventricle have to be opened to recover normal CSF circulation. Arachnoidal suspension and placement of a patulous dural graft are also important. Modified reconstruction of the cistern magna can be a good option for treatment of syringomyelia complicated by Chiari malformations.</p>
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Malformation d'Arnold-Chiari
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Chirurgie générale
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Syringomyélie
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Études rétrospectives
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Études de suivi
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Citerne cérébellomédullaire postérieure
Type d'étude:
Observational_studies
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Prognostic_studies
Limites du sujet:
Adolescent
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Adult
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Female
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Humans
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Male
langue:
Zh
Texte intégral:
Journal of Southern Medical University
Année:
2009
Type:
Article