Anomalies in the cognitive-executive functions in patients with Chiari Malformation Type I.

BACKGROUND: Over the last decade there has been growing evidence that neuropsychological deficits, principally in the executive functions, may be involved in the pathogenesis of Chiari Type I disease. The aim of this study is to compare changes in cognitive function in patients with Chiari Type I and healthy subjects. METHOD: The neuropsychological profile of these patients was compared with healthy controls. Three neuropsychological tests were administered to both Chiari Type I patients and healthy controls to assess the frontal executive functions of vigilance or selective attention, mental flexibility, planning and concept formation. RESULTS: The results suggest that Chiari Type I patients are affected in the processes of inhibition and self-control as well as in attention capacity and maintaining a course of thought and action. CONCLUSIONS: These results provide evidence of possible deficits or anomalies in the cognitive executive functions of patients with Chiari Type I.

Minimally Invasive Approach For Extraforaminal Synovial Cyst L5-S1.

Symptoms from synovial cysts are produced by neural compression in the spinal canal or the foramen. Few cases of extraforaminal synovial cyst have been published in the literature. This is a case report of a 65-year-old female who presented with a three-month history of sciatic pain and no relief with conservative treatment. MRI showed a left-sided extraforaminal synovial cyst at L5-S1 with compression of the L5 nerve root at the lateral portion of the foramen. Minimally invasive surgery for resection was performed using an extraforaminal tubular microscopic endoscopy-assisted approach. The patient improved clinically and remained symptom-free for the entire follow-up of 30 months.