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Symptomatic Chiari malformation and associated pathophysiology in pediatric and adult patients without myelodysplasia.
Fukushima, T; Matsuda, T; Tsuchimochi, H; Yamamoto, M; Tsugu, H; Tomonaga, M; Mitsudome, A; Utsunomiya, H; Asakawa, K.
Afiliación
  • Fukushima T; Department of Neurosurgery, School of Medicine, Fukuoka University.
Neurol Med Chir (Tokyo) ; 34(11): 738-43, 1994 Nov.
Article en En | MEDLINE | ID: mdl-7533267
The clinical characteristics of eight pediatric and five adult patients with Chiari malformation were evaluated. Six pediatric and five adult patients had associated syringomyelia. All patients initially underwent a suboccipital craniectomy with upper cervical (C-1 and/or C-2) laminectomy and duraplasty, and/or shunting procedures. The clinical characteristics of the pediatric and adult groups were compared. The mean interval between onset of symptoms and operation was shorter in the pediatric group (3 yrs 6 mos) than in the adult group (7 yrs 1 mo). Pediatric patients without syringomyelia had the shortest mean interval of 1 year 8 months. Preoperatively, the clinical features were more severe in the adult patients than in the pediatric patients. Postoperatively, seven of eight pediatric patients improved and one stabilized, while two of five adult patients improved, one stabilized, and in two the disease continued to progress despite multiple corrective procedures. Cine magnetic resonance imaging revealed correction of the abnormal cerebrospinal fluid (CSF) flow at the craniovertebral junction and decreased to-and-fro movement in the syrinx after posterior fossa decompression, which were closely correlated with the improvement of clinical features in pediatric patients. However, adult patients required further procedures because of the multifactorial nature of the disease. Evaluation of abnormal CSF pathways at the craniovertebral junction is important for investigating the pathogenesis of Chiari malformation and associated syringomyelia.
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Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Malformación de Arnold-Chiari / Defectos del Tubo Neural Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male / Middle aged Idioma: En Revista: Neurol Med Chir (Tokyo) Año: 1994 Tipo del documento: Article
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Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Malformación de Arnold-Chiari / Defectos del Tubo Neural Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male / Middle aged Idioma: En Revista: Neurol Med Chir (Tokyo) Año: 1994 Tipo del documento: Article