scholarly journals Foramen magnum decompression for the treatment of Arnold Chiari malformation type I with associated syringomyelia in an elderly patient

Spinal Cord ◽  
2004 ◽  
Vol 43 (4) ◽  
pp. 249-251 ◽  
Author(s):  
I Takigami ◽  
K Miyamoto ◽  
H Kodama ◽  
H Hosoe ◽  
S Tanimoto ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Chiari Malformation ◽  
Foramen Magnum ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type I ◽  
Arnold Chiari Malformation

Prognostic significance of C1–C2 facet malalignment after surgical decompression in adult Chiari malformation type I: a pilot study based on the Chicago Chiari Outcome Scale

2020 ◽  
pp. 1-7
Author(s):  
Michael Lumintang Loe ◽  
Tito Vivas-Buitrago ◽  
Ricardo A. Domingo ◽  
Johan Heemskerk ◽  
Shashwat Tripathi ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chiari Malformation ◽  
Prognostic Significance ◽  
Foramen Magnum ◽  
Bivariate Analysis ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Swallowing Function ◽  
Chiari Malformation Type I

OBJECTIVEThe authors assessed the prognostic significance of various clinical and radiographic characteristics, including C1–C2 facet malalignment, in terms of surgical outcomes after foramen magnum decompression of adult Chiari malformation type I.METHODSThe electronic medical records of 273 symptomatic patients with Chiari malformation type I who were treated with foramen magnum decompression, C1 laminectomy, and duraplasty at Mayo Clinic were retrospectively reviewed. Preoperative and postoperative Neurological Scoring System scores were compared using the Friedman test. Bivariate analysis was conducted to identify the preoperative variables that correlated with the patient Chicago Chiari Outcome Scale (CCOS) scores. Multiple linear regression analysis was subsequently performed using the variables with p < 0.05 on the bivariate analysis to check for independent associations with the outcome measures. Statistical software SPSS version 25.0 was used for the data analysis. Significance was defined as p < 0.05 for all analyses.RESULTSFifty-two adult patients with preoperative clinical and radiological data and a minimum follow-up of 12 months were included. Motor deficits, syrinx, and C1–C2 facet malalignment were found to have significant negative associations with the CCOS score at the 1- to 3-month follow-up (p < 0.05), while at the 9- to 12-month follow-up only swallowing function and C1–C2 facet malalignment were significantly associated with the CCOS score (p < 0.05). Multivariate analysis showed that syrinx presence and C1–C2 facet malalignment were independently associated with the CCOS score at the 1- to 3-month follow-up. Swallowing function and C1–C2 facet malalignment were found to be independently associated with the CCOS score at the 9- to 12-month follow-up.CONCLUSIONSThe observed results in this pilot study suggest a significant negative correlation between C1–C2 facet malalignment and clinical outcomes evaluated by the CCOS score at 1–3 months and 9–12 months postoperatively. Prospective studies are needed to further validate the prognostic value of C1–C2 facet malalignment and the potential role of atlantoaxial fixation as part of the treatment.

scholarly journals A Case of Chiari Malformation Type I : Improvement of Syringomyelia and Scoliosis by Foramen Magnum Decompression Alone

1999 ◽  
Vol 8 (11) ◽  
pp. 727-731
Author(s):  
Tetsuya Kubota ◽  
Kenichi Nishiyama ◽  
Akira Tamura ◽  
Kouichi Kawasaki ◽  
Hiroshi Masuda ◽  
...  
Keyword(s):  
Chiari Malformation ◽  
Foramen Magnum ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type I

scholarly journals Case Report: Acute obstructive hydrocephalus associated with infratentorial extra-axial fluid collection following foramen magnum decompression and durotomy for Chiari malformation type I

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 33 ◽  
Author(s):  
Sunil Munakomi ◽  
Binod Bhattarai ◽  
Pramod Chaudhary
Keyword(s):  
Chiari Malformation ◽  
Fourth Ventricle ◽  
Rare Complication ◽  
Obstructive Hydrocephalus ◽  
Fluid Collection ◽  
Foramen Magnum ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type I ◽  
Definitive Role

Acute obstructive hydrocephalus due to infratentorial extra-axial fluid collection (EAFC) is an extremely rare complication of foramen magnum decompression (FMD) and durotomy for Chiari malformation type I. Presence of infratentorial  EAFC invariably causes obstruction at the level of the fourth ventricle or aqueduct of Silvius, thereby indicating its definitive role in hydrocephalus. Pathogenesis of EAFC is said to be a local arachnoid tear as a result of durotomy, as this complication is not described in FMD without durotomy. Controversy exists in management. Usually EAFC is said to resolve with conservative management; so hydrocephalus doesn’t require treatment. However, in this case EAFC was progressive and ventriculo-peritoneal shunting (VPS) was needed for managing progressive and symptomatic hydrocephalus.

Yawning as a presenting symptom of Chiari malformation Type I: report of 2 cases

2015 ◽  
Vol 15 (6) ◽  
pp. 612-614 ◽  
Author(s):  
Bassel Zebian ◽  
Florence Rosie Avila Hogg ◽  
Richard Zhiming Fu ◽  
Ramanan Sivakumaran ◽  
Simon Stapleton
Keyword(s):  
Chiari Malformation ◽  
Craniocervical Junction ◽  
Foramen Magnum ◽  
Adolescent Females ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type I ◽  
Complete Cessation ◽  
First Case ◽  
Brainstem Compression

Yawning is thought to be a behavior regulated by the brainstem. Although excessive yawning has been reported in brainstem strokes, demyelination, and tumors, the cases presented here are the first reports of excessive yawning in patients with Chiari malformation Type I (CM-I). The authors believe that brainstem compression at the craniocervical junction and ensuing edema were implicated in this curious symptomatology. They describe excessive yawning as a presenting feature of CM-I in 2 adolescent females. The presentation was acute in the first case and more chronic in the second. Both patients underwent foramen magnum decompression, which resulted in complete cessation of the excessive yawning.

scholarly journals Negative Pressure Pulmonary Edema Following Foramen Magnum Decompression for Chiari Malformation Type I

2008 ◽  
Vol 48 (3) ◽  
pp. 137-139 ◽  
Author(s):  
Yoshitaka HIRANO ◽  
Taku SUGAWARA ◽  
Yoshiharu SATO ◽  
Koji SATO ◽  
Tomoya OMAE ◽  
...  
Keyword(s):  
Pulmonary Edema ◽  
Negative Pressure ◽  
Chiari Malformation ◽  
Foramen Magnum ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type I ◽  
Negative Pressure Pulmonary Edema

Factitious disorder in a patient with Arnold-Chiari malformation: A case report

2017 ◽  
Vol 41 (S1) ◽  
pp. S473-S473
Author(s):  
D. Celona ◽  
F. Sandri ◽  
E. Pascolo Fabrici ◽  
G. Peresson ◽  
D. Garino
Keyword(s):  
Chiari Malformation ◽  
Complete Resolution ◽  
Psychological Symptoms ◽  
Foramen Magnum ◽  
Type I ◽  
Factitious Disorder ◽  
Chiari Malformation Type I ◽  
Arnold Chiari Malformation ◽  
The Subject ◽  
Competing Interest

IntroductionThe factitious disorder is characterized by simulation or exaggeration by the subject of his/her physical or psychological symptoms to take a sick role. This disorder may be associated with a real disease, used to simulate other symptoms and receive treatment. Our case is represented by a 49-year-old man, affected by Arnold Chiari Malformation Type I (ACM-I), a structural defect in the cerebellum with extension of the cerebellar tonsils into the foramen magnum, without involving the brain stem. The patient had three surgical operations involving the complete resolution of the disease. However, the subject reported a worsening of all symptoms, with the outcome of a severe self-limitation, with admission to a residential care and taken over by the multidisciplinary equipe of the district. Symptoms, which mainly consisted in pain, motor functional impairment, headaches, slurred speech were not evaluated due to the ACM-I. This diagnosis was confirmed when there was the complete resolution of the symptoms in a date pointed by the patient.MethodsTo make an appropriate differential diagnosis, in addition to the neurological examination, the subject had psychiatric interviews and completed an MMPI evaluation.ResultsNeurological examinations revealed no residual outcome of the ACM-I. At MMPI there were not significant peaks. Regarding to the attitude towards this test and its validity, it appears an obvious attempt to lie from the patient, which tries to present himself in a favourable unrealistically way.ConclusionThis case shows that appropriate diagnosis can help health services in a better management of their resources in such situations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Initial management of hydrocephalus associated with Chiari malformation Type I–syringomyelia complex via endoscopic third ventriculostomy: an outcome analysis

2008 ◽  
Vol 108 (6) ◽  
pp. 1211-1214 ◽  
Author(s):  
Caroline Hayhurst ◽  
Jibril Osman-Farah ◽  
Kumar Das ◽  
Conor Mallucci
Keyword(s):  
Chiari Malformation ◽  
Endoscopic Third Ventriculostomy ◽  
Primary Treatment ◽  
Foramen Magnum ◽  
Cerebrospinal Fluid Leakage ◽  
Third Ventriculostomy ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type I ◽  
Radiographic Findings

Object The aim of this study was to evaluate the efficacy of endoscopic third ventriculostomy (ETV) in patients with Chiari malformation Type I (CM-I) and hydrocephalus with or without syringomyelia. Methods The authors identified, in a prospective endoscopy database, 16 adults and children (age range 2–68 years) with CM-I and hydrocephalus that had been managed with ETV. They reviewed the clinical features and radiographic findings for all patients. Fifteen patients underwent ETV as a primary treatment, whereas 1 patient underwent the procedure at the time of shunt failure. All patients had symptomatic hydrocephalus with either aqueductal or fourth ventricular outflow obstruction. The mean duration of follow-up was 42 months. Results Fifteen patients (94%) remain shunt free following ETV for CM-I. Five (83%) of the 6 patients with a syrinx had improvement or resolution of the syrinx following ETV. Six patients (37.5%) underwent foramen magnum decompression for persistent CM-I– or syrinx-related symptoms. There was no cerebrospinal fluid leakage or intracranial pressure–related problem following foramen magnum decompression. Conclusions Endoscopic third ventriculostomy provides a durable method of treatment for hydrocephalus associated with CM-I. It is effective as a primary treatment, and the authors advocate its use as a replacement for routine ventriculoperitoneal shunt insertion in these patients. Management of the hydrocephalus alone is often sufficient and may obviate decompression, although a significant proportion of patients will still need both procedures.

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