Surgical treatments of adolescent symptomatic Chiari malformation type Ⅰ / 中华神经医学杂志

ABSTRACT

Objective To summarize the clinical characteristics of adolescents with symptomatic Chiari malformation type Ⅰ,and evaluate the clinical results of small-range posterior fossa decompression on these patients.Methods Twelve adolescents with symptomatic Chiari malformation type Ⅰ,admitted to and underwent a standard small-range posterior decompression surgery in our hospital from December 2006 to December 2011,were chosen; their clinical data were retrospectively analyzed.The standard surgical technique was composed of limited bone cut in 2 cm×2 cm,weak current coagulation in shrinking the tonsils,probe of aqueduct cerebrospinal fluid outflow tract and Magendie's foramen of the fourth ventricle,and suture of the dural grafting with patch ofautologous fascia.Preoperative and postoperative symptoms and sizes of syringomyelia were compared.Results Short-term follow-up showed that the clinical symptoms of patients improved significantly,and MRI confirmed that the syringomyelia disappeared or shrank in all the patients and the shape of cisterna magna recovered.Eight patients accepted follow-up for more than six months,showing continues improvement of clinical symptoms.Conclusion Small-range posterior fossa decompression surgery is important means to alleviate adolescent symptomatic Chiari malformation type Ⅰ.