Technique for Mini-open Decompression of Chiari Type I Malformation in Adults

2017 ◽  
Vol 13 (4) ◽  
pp. 465-470 ◽  
Author(s):  
Peyman Pakzaban
Keyword(s):  
Neurological Complications ◽  
Craniocervical Junction ◽  
Type I ◽  
Invasive Approach ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Suboccipital Craniectomy ◽  
Upper Cervical ◽  
Mini Open ◽  
Chiari Type I

Abstract BACKGROUND: The technique for decompression of Chiari type I malformation relies on open exposure of craniocervical junction for suboccipital craniectomy and upper cervical laminectomy with or without duraplasty. There is no detailed technical report of a minimally invasive approach for Chiari decompression in adults. OBJECTIVE: To describe a mini-open technique for decompression of Chiari type I malformation (including duraplasty) in adults. METHODS: Six consecutive adult patients with symptomatic Chiari type I malformation underwent decompression through a 3 to 4 cm midline incision via a speculum retractor. All patients underwent a limited suboccipital craniectomy and C1 laminectomy with an ultrasonic bone scalpel. All patients underwent duraplasty with a synthetic dural substitute. In the 2 patients with syringomyelia, the arachnoid was opened and intradural dissection was carried out. In the remaining 4 patients, the arachnoid was left intact. RESULTS: All operations were completed successfully through the mini-open exposure. Mean surgery time, blood loss, and length of stay were 114 min, 55 mL, and 1.3 days, respectively. Mean follow-up was 13.2 months (range 9-18). All patients had excellent clinical outcomes as defined by scores of 15 (3 patients) or 16 (3 patients) on Chicago Chiari Outcome Scale. There were no neurological complications or cerebrospinal fluid leaks. Postop computed tomography revealed good boney decompression. In the 2 patients with syringomyelia, MRI at 6 months revealed resolution of the syrinx. CONCLUSION: Decompression of Chiari type I malformation in adults can be performed safely and effectively through the mini-open exposure described in this report.

Chiari Type I Malformation Presenting with Unilateral Hearing Loss

2021 ◽  
Author(s):  
Abdulhamid Ciçek ◽  
Jeroen Cortier ◽  
Sarah Hendrickx ◽  
Johan Van Cauwenbergh ◽  
Lien Calus ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Young Woman ◽  
Surgical Decompression ◽  
Unilateral Hearing Loss ◽  
Type I ◽  
Frequent Symptom ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Suboccipital Craniectomy ◽  
Chiari Type I

Abstract Introduction Chiari type I malformations can present in different ways, but the most frequent symptom is an occipitocervical headache. Hearing loss as the main presenting symptom is rare. Case A young woman with progressive left-sided unilateral hearing loss was diagnosed with a Chiari type I malformation. She underwent a suboccipital craniectomy with C1 laminectomy and duraplasty. The hearing loss had resolved postoperatively with normalization of the audiometry. Conclusion Chiari type I malformation can present solely with hearing loss. Improvement after surgical decompression is possible. This phenomenon is not emphasized well enough within the neurologic community. In this report, we present a summary of the pathophysiology and management in Chiari type I malformations.

scholarly journals Chiari type I malformation with cervicothoracic syringomyelia subterfuge as flail arm syndrome

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Zhi Gang  Lan ◽  
Seidu A. Richard ◽  
Jiagang Liu ◽  
Chao You
Keyword(s):  
Neuromuscular Disorders ◽  
Neurological Complications ◽  
Type I ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Detection And Diagnosis ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Chiari Type I

Chiari type I malformation with cervicothoracic syringomyelia although very common in clinical practice usually in children can progress slowly and mimic muscular dystrophies in adulthood. We present a rare adult case of Chiari type I malformation with cervicothoracic syringomyelia subterfuge as Flail arm syndrome. A 44- year-old man was diagnosed with congenital type I Chiari malformation with cervicothoracic syringomyelia about 21 years ago without surgery. His health status deteriorated over the years until 21 days prior to presentation when he had severe pain in the right knee. In his upper limbs, he had bilateral corresponding severe weakness of 0/5 proximal strength and 0/5 strength in his distal muscles. Magnetic resonance imaging (MRI) revealed an enlargement of the spinal cord from C1-C4 level with a mass that appeared hypo-dense on T1 and hyperdense on T2. Syringomyelia is a potentially serious neurologic condition that can mimic other neuromuscular disorders. Early detection and diagnosis with MRI is crucial to avoid irreversible neurological complications. We suggest that whether asymptomatic or symptomatic, decompressive surgery should be carried out to allow for free flow of cerebrospinal fluid thereby improving the quality of life for the patient.

Arnold-Chiari type I malformation presenting as benign paroxysmal positional vertigo in an adult patient

2006 ◽  
Vol 121 (3) ◽  
pp. 296-298
Author(s):  
M Unal ◽  
C Bagdatoglu
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Foramen Magnum ◽  
Upper Cervical Spine ◽  
Type I ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Positional Vertigo ◽  
Upper Cervical ◽  
Chiari Type I ◽  
Paroxysmal Positional Vertigo

Arnold-Chiari malformations are a group of congenital hindbrain and spinal cord abnormalities characterized by herniation of the contents of the posterior cranial fossa caudally through the foramen magnum into the upper cervical spine. It is important to recognize Arnold-Chiari type I malformation in the differential diagnosis of adult vertigo cases. We present a 51-year-old patient with Arnold-Chiari type I malformation that was initially diagnosed as posterior semicircular canal benign paroxysmal positional vertigo.

Hydrocephalus and Chiari type I malformation

2011 ◽  
Vol 27 (10) ◽  
pp. 1653-1664 ◽  
Author(s):  
Concezio Di Rocco ◽  
Paolo Frassanito ◽  
Luca Massimi ◽  
Simone Peraio
Keyword(s):  
Type I ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Chiari Type I

scholarly journals Chiari type I malformation and postoperative respiratory failure

2000 ◽  
Vol 47 (12) ◽  
pp. 1220-1223 ◽  
Author(s):  
Daryl L. Williams ◽  
Hamed Umedaly ◽  
I. Lynn Martin ◽  
Anthony Boulton
Keyword(s):  
Respiratory Failure ◽  
Type I ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Postoperative Respiratory Failure ◽  
Chiari Type I

Chiari Type I Malformation Associated With Verbal Fluency Impairment

2018 ◽  
Vol 61 (10) ◽  
pp. 2458-2466
Author(s):  
Esther Lázaro ◽  
Maitane García ◽  
Ane Ibarrola ◽  
Imanol Amayra ◽  
Juan Francisco López-Paz ◽  
...  
Keyword(s):  
Verbal Fluency ◽  
Type I ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Chiari Type I

The Association of Chiari Type I Malformation and Neurofibromatosis Type 1

1993 ◽  
Vol 32 (3) ◽  
pp. 189-190 ◽  
Author(s):  
Joseph Dooley ◽  
Daniel Vaughan ◽  
Michael Riding ◽  
Peter Camfield
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Chiari Malformation ◽  
Neurofibromatosis Type ◽  
Foramen Magnum ◽  
Type I ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Chiari Type I ◽  
Chiari Malformations

The association of neurofibromatosis type 1 (NF1) with Chiari malformations of the cerebellum and brain stem has been reported on only two previous occasions.1,2 The pathogenesis of both conditions has remained unclear, although the Chiari type I malformation is most likely due to hypoplasia of the posterior fossa with subsequent extension of the cerebellum through the foramen magnum.3 NF1 is also associated with a variety of cerebral dysplasias.4 We present a patient with both of these dysplastic lesions whose Chiari malformation was asymptomatic.

scholarly journals A Possible Association between Arnold-Chiari Type I Malformation and Epilepsy: Case Series and Review

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Hadelsberg Uri P ◽  
Goldberg Hadassah ◽  
Marianayagam Neelan J ◽  
Rajz Gustavo
Keyword(s):  
Case Series ◽  
Type I ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Chiari Type I
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