scholarly journals Basilar impression associated with impacted cisterna magna, spastic paraparesis and distress of balance: case report

2006 ◽  
Vol 64 (3a) ◽  
pp. 668-671 ◽  
Author(s):  
José Alberto Gonçalves da Silva ◽  
Maurus Marques de Almeida Holanda ◽  
Maria do Desterro Leiros ◽  
Luiz Ricardo Santiago Melo ◽  
Antônio Fernandes de Araújo ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Fossa ◽  
Spastic Paraparesis ◽  
Lower Limbs ◽  
Posterior Fossa Decompression ◽  
Basilar Impression ◽  
Cisterna Magna ◽  
Balance Case ◽  
Nuchal Rigidity ◽  
Cerebellar Tonsils

We report on a 48 years-old man with basilar impression without syringohydromyelia, in which the cisterna magna was impacted by the cerebellar tonsils. Six months after posterior fossa decompression there was the disappearance of nuchal rigidity, vertigo, spastic paraparesis and improvement of balance. Nevertheless hyperreflexia and diminished pallesthesia of the lower limbs persisted.

scholarly journals Impacted cisterna magna without syringomyelia associated with spastic paraparesis: case report

2006 ◽  
Vol 64 (3a) ◽  
pp. 672-675 ◽  
Author(s):  
José Alberto Gonçalves da Silva ◽  
Maria do Desterro Leiros da Costa ◽  
Maurus Marques de Almeida Holanda ◽  
Luiz Ricardo Santiago Melo ◽  
Antônio Fernandes Almeida de Araújo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Posterior Fossa ◽  
Clinical Picture ◽  
Spastic Paraparesis ◽  
Resonance Imaging ◽  
Cisterna Magna ◽  
Symptoms And Signs ◽  
Cerebellar Tonsils

We report on a 49 year old man with impacted cisterna magna without the presence of syringohydromyelie (SM). The clinical picture was characterized by spastic paraparesis. Magnetic resonance imaging depicted a cisterna magna filled by the cerebellar tonsils. Six months after osteodural-neural decompression of the posterior fossa there was resolution of neurological symptoms and signs with the exception of hyperactive patellar and Achilles reflexes.

scholarly journals Retrospective study of patients with Chiari: malformation submitted to surgical treatment

2008 ◽  
Vol 66 (2a) ◽  
pp. 184-188 ◽  
Author(s):  
Mário Augusto Taricco ◽  
Luiz Ricardo Santiago Melo
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Posterior Fossa ◽  
Chiari Malformation ◽  
Posterior Fossa Decompression ◽  
Basilar Impression ◽  
Iii Ventricle ◽  
Complementary Techniques ◽  
Cerebellar Tonsils

The Chiari malformation (CM) is characterized by variable herniation of one or both cerebellar tonsils, associated or not with displacement of the hindbrain structures into the vertebral canal. This is a retrospective study of 29 patients with CM submitted to surgical procedure between 1990 and 2003. There were 14 females and 15 males whose ages ranged from 16 to 65 years. There were seven patients with isolated CM, 12 associated with syringomyelia (SM), three associated with basilar impression (BI) and seven associated with SM and BI. The surgery was based on posterior fossa decompression. In seven patients a catheter was introduced from the subarachnoid space into the III ventricle and five were submitted to tonsillectomy. Twenty-one patients improved, one worsened, one remained unchanged, four missed follow up and two died. We conclude that the best results with CM surgery are obtained by an effective posterior fossa decompression. Those CM cases associated with other abnormalities, such as SM and BI, probably need complementary techniques which will be the theme for new prospective studies.

scholarly journals Posterior fossa decompression with tonsillectomy in 104 cases of basilar impression, Chiari malformation and/or syringomyelia

2011 ◽  
Vol 69 (5) ◽  
pp. 817-823 ◽  
Author(s):  
José Alberto Gonçalves da Silva ◽  
Adailton Arcanjo dos Santos Jr ◽  
Luiz Ricardo Santiago Melo ◽  
Antônio Fernandes de Araújo ◽  
Giseuda Pessoa Regueira
Keyword(s):  
Surgical Treatment ◽  
Posterior Fossa ◽  
Chiari Malformation ◽  
Craniovertebral Junction ◽  
Posterior Fossa Decompression ◽  
Basilar Impression ◽  
Upward Migration ◽  
Cisterna Magna ◽  
Suboccipital Craniectomy ◽  
Prime Objective

The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM) and/or syringomyelia (SM) is based on the restoration of the normal cerebrospinal fluid (CSF) dynamics at the craniovertebral junction through the creation of a large artificial cisterna magna. A small suboccipital craniectomy has been emphasized to avoid caudal migration of the hindbrain structures into the vertebral canal. Nevertheless, the results showed downward migration of the hindbrain related to that type of craniectomy. The authors present, otherwise, the results of 104 cases of BI, CM and/or SM, whose surgical treatment was characterized by a large craniectomy with the patient in the sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large artificial cisterna magna. A significant upward migration of the posterior fossa structures was detected by postoperative magnetic resonance imaging.

Case Report of Cerebellar Endometriosis

2020 ◽  
Vol 81 (04) ◽  
pp. 372-376
Author(s):  
Michael Meggyesy ◽  
Michael Friese ◽  
Joachim Gottschalk ◽  
Uwe Kehler
Keyword(s):  
Case Report ◽  
Estrogen Receptors ◽  
Posterior Fossa ◽  
Cyst Wall ◽  
Clinical Course ◽  
Correct Diagnosis ◽  
Posterior Fossa Decompression ◽  
Chronic Hydrocephalus ◽  
Brainstem Compression ◽  
Intracranial Cysts

AbstractEndometriosis is a disorder in women which is characterized by extrauterine manifestations. We describe a case of cerebellar endometriosis in a 39-year-old woman who underwent posterior fossa decompression multiple times without establishing a correct diagnosis. Her neurologic status progressively worsened due to chronic hydrocephalus and brainstem compression by cysts. Late in the clinical course, histology from the cyst wall was taken that revealed endometriosis with clear cells and positive immunohistology for progesterone and estrogen receptors. Treatment with gestagens was started but did not improve the patient's status. In patients with chronic recurring intracranial cysts and hydrocephalus, cerebral endometriosis should be considered.

scholarly journals Impacted cisterna magna without syringomyelia associated or not with basilar impression and/or Chiari malformation

2013 ◽  
Vol 32 (01) ◽  
pp. 40-47
Author(s):  
José Alberto Gonçalves da Silva ◽  
Adailton Arcanjo dos Santos Júnior ◽  
José Demir Rodrigues
Keyword(s):  
Surgical Treatment ◽  
Posterior Fossa ◽  
Chiari Malformation ◽  
Sitting Position ◽  
Basilar Impression ◽  
Tonsillar Herniation ◽  
Upward Migration ◽  
Cisterna Magna ◽  
Large Opening ◽  
Magnetic Resonance Imaging Mri

Abstract Objective: The objective of this paper is to analyze the surgical treatment of impacted cisterna magna without syringomyelia (SM) associated or not with basilar impression (BI) and/or Chiari malformation (CM). Method: The authors present, in this work, the results of five cases with impacted cisterna magna without SM which were associated with BI in four cases, tonsillar herniation in three patients when they were in the sitting position and in the other two cases there was not herniation in the sitting position. Results: The surgical treatment was characterized by a large craniectomy with the patient in the sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large artificial cisterna magna. An upward migration of the posterior fossa structures was detected by postoperative magnetic resonance imaging (MRI). Conclusion: The surgical treatment of impacted cisterna magna without SM remains unclear, however, a large craniectomy associated with tonsillectomy and creation of a large cisterna magna showed good results and a tendency of upward migration of the posterior fossa structures.

scholarly journals Improvement of Hydrocephalus in Patients with Chiari Malformation After Posterior Fossa Decompression

2018 ◽  
Vol 27 (1) ◽  
pp. 71-73
Author(s):  
Lindolfo Carlos Heringer ◽  
Matheus Fernandes De Oliveira ◽  
Ulysses Oliveira De Sousa ◽  
Wanderley Cerqueira De Lima ◽  
Ricardo Vieira Botelho
Keyword(s):  
Posterior Fossa ◽  
Chiari Malformation ◽  
Clinical Symptoms ◽  
Foramen Magnum ◽  
Posterior Fossa Decompression ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Cisterna Magna ◽  
Long Time ◽  
Small Posterior Fossa

Introduction. The association between hydrocephalus and Chiari malformation (CM) has not been described frequently. Ventricular dilation affects 7% to 10% of patients with CM, but the ideal choice of surgical treatment is controversial. Wereport a case of a patient with Chiari malformation and hydrocephalus with improvement in clinical symptoms and ventricular dilatation. Case Description. A 19-year-old male complaining of frontal headache when coughing, laughing and during valsalva maneuvers, associated with dizziness for 2 months. Magnetic resonance (MR) showed hydrocephalus and small posterior fossa with overcrowding of contents, characterizing Chiari malformation type I, with cerebellar tonsils protruding through magnum foramen. Patient underwent surgery with posterior fossa decompression in a semi-sitting position and removal of the arc C1.After 3 months of follow-up, headache disappeared becoming asymptomatic. Control MR showed improvement of hydrocephalus with restoration of the cisterna magna and CSF flow. Discussion. Hydrocephalus has been related to CM for a long time. In our case, we performed treatment with intradural and intra-arachnoidal approach with bilateral tonsillectomy without placing ventricular shunt. The cisterna magna was “recreated”. There was improvement of hydrocephalus with decreased Evans ratio index and symptoms disappearance. Although there is no other studies addressing such matter, in this case, the improvement suggests that the CSF compression at the foramen magnum was the cause of associated hydrocephalus with Chiari malformation. 

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