Spontaneous Resolution of Chiari I Malformation and Syringomyelia: Case Report and Review of the Literature

Neurosurgery ◽  
2001 ◽  
Vol 48 (3) ◽  
pp. 664-667 ◽  
Author(s):  
Jörg Klekamp ◽  
Giorgio Iaconetta ◽  
Madjid Samii
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Case Report ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Spontaneous Resolution ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Chiari I ◽  
Resonance Imaging Scan

Abstract OBJECTIVE AND IMPORTANCE Indications for surgery and the surgical technique of foramen magnum decompression for patients with Chiari I malformation and syringomyelia are controversial issues. This case report supports the view that observation may be adequate for patients without progressive symptoms or with mild clinical symptoms. CLINICAL PRESENTATION A 37-year-old woman presented with a 3-month history of burning dysesthesias and hypesthesia in her right arm. A neurological examination revealed hypesthesia in the right trigeminal distribution. A magnetic resonance imaging scan revealed a Chiari I malformation with syringomyelia between C2 and T2. No hydrocephalus was observed. CLINICAL COURSE Because the patient's symptoms regressed spontaneously, surgery was not performed. Thirty-two months after her initial examination, the patient was asymptomatic. A second magnetic resonance imaging scan was obtained, which demonstrated complete spontaneous resolution of the Chiari I malformation and syringomyelia. CONCLUSION We attribute the regression of the patient's symptoms to spontaneous recanalization of cerebrospinal fluid pathways at the foramen magnum, which most likely was due to rupture of the arachnoid membranes that had obstructed cerebrospinal fluid flow.

scholarly journals A Giant Solitary Solid Hemangioblastoma: A Case Report and Review of The Literature

2017 ◽  
Vol 14 (2) ◽  
pp. 47-50
Author(s):  
Rajeev Bhandari ◽  
Gopal R Sharma ◽  
Prakash Bista ◽  
Rajiv Jha ◽  
Rajendra Shrestha ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Case Report ◽  
Vascular Tumor ◽  
Posterior Cranial Fossa ◽  
Magnetic Resonance Imaging Scan ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Cranial Fossa ◽  
Resonance Imaging Scan

We present a case of solitary vascular tumor on posterior cranial fossa in a 15-year-old female who had a complaint of headache on/off for six months with associated dizziness, nausea, vomiting and vertigo. Well circumscribed solid vascular mass was localized on posterior fossa by computed tomography along with magnetic resonance imaging scan. Furthermore, the diagnosis was confirmed by surgical findings and histological examinations.Nepal Journal of Neuroscience, Vol. 14, No. 2,  2017 Page: 47-50 

Plasma Cell Granuloma of the Middle Ear and Mastoid

1992 ◽  
Vol 101 (1) ◽  
pp. 92-94 ◽  
Author(s):  
Nick C. Benton ◽  
Harold W. Korol ◽  
Lawrence T. Smyth
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Plasma Cell ◽  
Middle Ear ◽  
Plasma Cell Granuloma ◽  
Magnetic Resonance Imaging Scan ◽  
Vascular Compression ◽  
Resonance Imaging ◽  
First Case ◽  
Resonance Imaging Scan

We present the case of a 37-year-old man with plasma cell granuloma affecting the middle ear and mastoid. At magnetic resonance imaging scan, the lesion appeared as a homogeneously enhancing mass of soft tissue replacing the majority of the mastoid bone and causing vascular compression. After surgical resection, microscopic examination showed predominantly plasmacytes, and histochemical studies confirmed a polyclonal origin consistent with nonneoplastic plasma cell granuloma. We believe this is the first case report of plasma cell granuloma affecting the middle ear and mastoid.

Hiccups Attributable to Syringobulbia and/or Syringomyelia Associated with a Chiari I Malformation: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 224-227 ◽  
Author(s):  
Toshitaka Seki ◽  
Kazutoshi Hida ◽  
JangBo Lee ◽  
Yoshinobu Iwasaki
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
Foramen Magnum Decompression ◽  
Chiari I ◽  
Cerebellar Symptoms ◽  
Intractable Hiccups

Abstract OBJECTIVE AND IMPORTANCE Approximately 20 to 50% of patients with syringomyelia associated with Chiari malformations exhibit cranial nerve or cerebellar symptoms. However, hiccups represent a rare clinical manifestation of this disorder. We report a case of intractable hiccups resulting from syringobulbia associated with a Chiari I malformation, which was successfully treated with foramen magnum decompression. CLINICAL PRESENTATION We report the case of a patient who presented with syringomyelia and syringobulbia associated with a Chiari I malformation, manifested as intractable hiccups and neurological deficits. Magnetic resonance imaging scans demonstrated syringobulbia in the dorsal medullary region and a large cervical syrinx from C2 to C6–C7, associated with a Chiari I malformation. INTERVENTION Foramen magnum decompression and a C1 laminectomy were performed. One month later, the intractable hiccups disappeared and the neurological symptoms demonstrated improvement. CONCLUSION Postoperative magnetic resonance imaging scans demonstrated enlargement of the subarachnoid space in the posterior fossa and disappearance of the syringobulbia. There has been no recurrence of intractable hiccups and syringobulbia in 6 months after surgery. Magnetic resonance imaging of the brainstem is an important diagnostic procedure for intractable hiccups, because syringobulbia associated with a Chiari malformation represents a surgically treatable disorder, although the incidence is low.

Association of Chiari I Malformation, Mental Retardation, Speech Delay, and Epilepsy: A Specific Disorder?

Neurosurgery ◽  
2001 ◽  
Vol 49 (5) ◽  
pp. 1099-1104 ◽  
Author(s):  
Salvatore Grosso ◽  
Roberto Scattolini ◽  
Galluzzi Paolo ◽  
Rosanna Maria Di Bartolo ◽  
Guido Morgese ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Mental Retardation ◽  
Magnetic Resonance ◽  
Incidental Finding ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Speech Delay ◽  
Resonance Imaging ◽  
Cavum Septum Pellucidum ◽  
Chiari I

ABSTRACT OBJECTIVE The Chiari I malformation is defined as tonsillar herniation of at least 3 to 5 mm below the foramen magnum. Although Chiari I malformation is considered to derive from a mesodermal disorder resulting in underdevelopment of the posterior fossa relative to its content, evidence for a possible heterogeneous etiology also has been reported. The aim of the present study is to elucidate the relationship between Chiari I malformation and mental retardation, speech delay, and epilepsy to consider a possible specific pathogenetic background. METHODS Thirty-five patients with Chiari I malformations were identified by use of magnetic resonance imaging during a period between 1993 and 1999. The study consisted of nine patients (four boys and five girls) who were affected by mental retardation, speech delay, and epilepsy. All patients underwent electroencephalography and brain and cervical spine magnetic resonance imaging. RESULTS All patients were mentally retarded with a mean intelligence quotient of 50. Seven patients had a positive history for speech delay, and five were epileptic. Electroencephalograms demonstrated abnormalities in seven patients. The mean tonsillar displacement was 10.1 mm. A thin corpus callosum and a wide cavum septum pellucidum were present in three patients. Neither hydromyelia nor scoliosis was observed. No correlation between the degree of the ectopia and clinical manifestation was noted. CONCLUSION The association of Chiari I malformation with epilepsy, speech delay, and mental retardation may not be a mere incidental finding but may be a marker for a different pathogenetic background.

SYMPTOMATIC CHIARI TYPE I MALFORMATION AFTER RADIATION THERAPY IN AN INFANT

Neurosurgery ◽  
2007 ◽  
Vol 60 (4) ◽  
pp. E782-E782 ◽  
Author(s):  
Caitlin E. Hoffman ◽  
Eric Lis ◽  
Suzanne L. Wolden ◽  
Mark M. Souweidane
Keyword(s):  
Magnetic Resonance Imaging ◽  
Radiation Therapy ◽  
Magnetic Resonance ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Type I ◽  
Malignant Rhabdoid Tumor ◽  
Resonance Imaging ◽  
Anterior Cranial Base ◽  
Chiari I

Abstract OBJECTIVE One previous case report has described the development of a Chiari I malformation in a child after fractionated radiation therapy to the anterior cranial base. The authors present an additional case of a 17-month-old girl treated for an isolated, malignant, rhabdoid tumor of the right neck with neoadjuvant chemotherapy, surgical exploration, and radiation therapy. CLINICAL PRESENTATION The patient developed a Chiari I malformation and cervical syringomyelia 1.5 years after the treatment. The patient experienced two episodes of unresponsiveness before diagnosis, and the malformation was then identified on magnetic resonance imaging scans. INTERVENTION Suboccipital decompressive craniectomy, and C1 laminectomy with autologous duraplasty were performed. RESULTS Postoperative magnetic resonance imaging scans revealed reconstitution of cerebrospinal fluid at the foramen magnum and ascent of the cerebellar tonsils. The patient remains asymptomatic 5.5 years after treatment. CONCLUSION The importance of this association is discussed in the context of the increasing use of radiation therapy in young children and infants.

Evaluating the Effect of Decompression Surgery on Cerebrospinal Fluid Flow and Intracranial Compliance in Patients with Chiari Malformation with Magnetic Resonance Imaging Flow Studies

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. 1344-1351 ◽  
Author(s):  
Anusha Sivaramakrishnan ◽  
Noam Alperin ◽  
Sushma Surapaneni ◽  
Terry Lichtor
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Chiari I Malformation ◽  
Magnetic Resonance Images ◽  
Decompression Surgery ◽  
Intracranial Volume ◽  
Resonance Imaging ◽  
Intracranial Compliance ◽  
Chiari I

Abstract OBJECTIVE: To quantify the effect of decompression surgery on craniocervical junction hydrodynamics and on global intracranial compliance (ICC) in patients with Chiari I malformation by use of magnetic resonance measurements of cerebrospinal fluid and blood flow. Studying the effect of decompression surgery may improve our understanding of the pathophysiological characteristics of Chiari I malformation and aid in identifying patients who will benefit from the procedure. METHODS: Twelve patients were studied with a 1.5-T magnetic resonance imaging scanner before and after decompression surgery. Cine phase contrast magnetic resonance images were used to quantify maximum cord displacement, maximum systolic cerebrospinal fluid velocity and volumetric flow rate, and overall ICC. ICC was derived by use of a previously reported method that measures small changes in intracranial volume and pressure that occur naturally with each cardiac cycle. RESULTS: After surgery, changes were documented both in the local hydrodynamic parameters and in ICC. However, only the change in ICC, an average increase of more than 60%, was statistically significant. Increased ICC, which was associated with improved outcome, was measured in 10 of the 12 patients, no significant change was documented in 1 patient, and decreased ICC was measured in 1 patient whose symptoms persisted after surgery. CONCLUSION: An increase in the overall compliance of the intracranial compartment is the most significant and consistent change measured after decompression surgery. Changes in cord displacement, cerebrospinal fluid velocities, and flow in the craniospinal junction were less consistent and less affected by the operation. Thus, ICC may play an important role in the outcome of decompression surgery related to improving symptoms and restoring normal neurological hydrodynamics in patients with Chiari I malformations.

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