Communication of hydromyelic cavity with the fourth ventricle shown by combined Pantopaque and air myelography

1973 ◽  
Vol 38 (2) ◽  
pp. 235-238 ◽  
Author(s):  
Hector E. James ◽  
Luis Schut ◽  
Patrick P. Pasquariello
Keyword(s):  
Respiratory Distress ◽  
Chiari Malformation ◽  
Fourth Ventricle ◽  
Radiological Evaluation ◽  
Content Type ◽  
Feeding Difficulties ◽  
Arnold Chiari Malformation ◽  
Fine Print

✓ A 3-year-old child who had had respiratory and feeding difficulties at birth was admitted because of respiratory distress and stridor. Radiological evaluation with Pantopaque and air myelography revealed an Arnold-Chiari malformation associated with extensive hydromyelia and communication between the fourth ventricle and the hydromyelic cavity.

Mesencephalic spur (beaking deformity of the tectum) in Arnold-Chiari malformation

1976 ◽  
Vol 45 (3) ◽  
pp. 315-320 ◽  
Author(s):  
Adelola Adeloye
Keyword(s):  
Chiari Malformation ◽  
Type Ii ◽  
Content Type ◽  
Arnold Chiari Malformation ◽  
Degrees Of Severity ◽  
Fine Print

✓ The beaking deformity of the tectum, referred to in this paper as the mesencephalic spur, is regularly present in the Type II variety of the Arnold-Chiari malformation in varying degrees of severity. When the mesencephalic spur is related to associated myelomeningocele, it was found that the more extensive the myelomeningocele, and the older the affected children, the more prominent was the mesencephalic spur.

Considerations in the diagnosis and treatment of syringomyelia and the Chiari malformation

1982 ◽  
Vol 57 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Leslie D. Cahan ◽  
John R. Bentson
Keyword(s):  
Chiari Malformation ◽  
Craniocervical Junction ◽  
Accurate Diagnosis ◽  
Posterior Fossa Surgery ◽  
Radiological Evaluation ◽  
Content Type ◽  
The Impact ◽  
Tomography Scanning ◽  
Results Of Surgery ◽  
Fine Print

✓ A series of patients with abnormalities of the craniocervical junction with and without syringomyelia is reviewed. The impact of computerized tomography scanning on current radiological evaluation is discussed. Air myelography may no longer be necessary for accurate diagnosis. While the results of surgery for the Chiari malformation were good, at least one-half of the patients with syringomyelia showed continued progression of symptoms after posterior fossa surgery. More effective surgical therapy requires a better understanding of the pathogenesis of the syrinx.

Experience with Arnold-Chiari malformation, 1960 to 1970

1976 ◽  
Vol 45 (4) ◽  
pp. 416-422 ◽  
Author(s):  
Ruben J. Saez ◽  
Burton M. Onofrio ◽  
Takehiko Yanagihara
Keyword(s):  
Retrospective Study ◽  
Neurological Deficit ◽  
Chiari Malformation ◽  
Prognostic Significance ◽  
Cerebellar Dysfunction ◽  
Content Type ◽  
Arnold Chiari Malformation ◽  
Clinical Syndromes ◽  
Suboccipital Decompression ◽  
Fine Print

✓ A retrospective study of 60 adult patients with Arnold-Chiari malformation revealed that certain presenting clinical syndromes, although not pathognomonic, seemed to have definite prognostic significance. Surgical management by suboccipital decompression led to remarkable and enduring improvement in 65% of patients followed for as long as 14 years. In some patients, however, the initial postoperative benefit tended to fade into an insidious progression of neurological deficit. Despite operation, 18.6% of patients eventually experienced progressive neurological deterioration. Patients who presented with paroxysmal intracranial hypertension or cerebellar dysfunction had the best prognosis. Evidence of central cord involvement was the single most detrimental factor to neurological recovery.

Early descriptions of the Arnold-Chiari malformation

1972 ◽  
Vol 37 (5) ◽  
pp. 543-547 ◽  
Author(s):  
Peter W. Carmel ◽  
William R. Markesbery
Keyword(s):  
Brain Stem ◽  
Chiari Malformation ◽  
Fourth Ventricle ◽  
Cervical Canal ◽  
Content Type ◽  
Anatomical Features ◽  
John Cleland ◽  
Arnold Chiari Malformation ◽  
The Brain ◽  
Cerebellar Tonsils

✓ John Cleland described an unusual congenital anomaly of the brain stem in 1883 in which the medulla was elongated, the fourth ventricle extended into the cervical canal, and the inferior vermis distorted caudally. In 1891 Chiari described two types of brain stem malformation; in one the cerebellar tonsils extended into the cervical canal without medullary deformation, while in the other there was caudal extension of the brain stem and cerebellum and prolongation of the inferior vermis into the cervical canal. The second type was termed the “Arnold-Chiari” malformation by other authors in 1907, and corresponds to the condition described earlier by Cleland. The anatomical features and differences between the types of malformation are tabulated.

Acute obstructive hydrocephalus associated with infratentorial subdural hygromas complicating Chiari malformation Type I decompression

2005 ◽  
Vol 103 (4) ◽  
pp. 752-755 ◽  
Author(s):  
Laurence A. G. Marshman ◽  
Jonathan C. Benjamin ◽  
Sanjiv J. Chawda ◽  
Karoly M. David
Keyword(s):  
Mr Imaging ◽  
Chiari Malformation ◽  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
External Ventricular Drain ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Shunt Insertion ◽  
Content Type ◽  
Fine Print

✓ Obstructive hydrocephalus complicating foramen magnum decompression (FMD) for a Chiari malformation (CM) Type I is rare. Two female patients (17 and 55 years old) presented with strain-related headaches. In both cases magnetic resonance (MR) imaging studies confirmed a CM Type I, which was accompanied by syringomyelia in one case. Both patients underwent uncomplicated FMD with good initial recovery. Unfortunately, conditions in both patients deteriorated, with severe headaches occurring between Days 5 and 6 post-FMD. Decreased consciousness occurred in one case. In both patients, computerized tomography scanning demonstrated an acute obstructive hydrocephalus associated with bilateral infratentorial extraaxial fluid collections (EAFCs). In addition, left parafalcine and convexity EAFCs were present in one case. An emergency external ventricular drain was required in one patient, with delayed conversion to a ventriculoperitoneal shunt. Spontaneous resolution occurred in the other patient without neurosurgical intervention. In both cases, MR imaging confirmed that each EAFC was subdural, resembled cerebrospinal fluid (CSF), and had distorted the superior cerebellum anteroinferiorly. Despite upper fourth ventricle/aqueduct compromise in one case, normal aqueduct flow artifacts were apparent on examination. All EAFCs resolved spontaneously. Obstructive hydrocephalus complicating FMD is rare but invariably associated with infratentorial EAFCs, which were confirmed to be subdural hygromas in this report. The authors assert that hydrocephalus results from upper fourth ventricle/aqueduct compromise as a result of CSF subdural dissection following a pinhole arachnoid tear on durotomy. Because such hygromas spontaneously resolve, permanent shunt insertion should be avoided.

Myelomeningocele before birth

1978 ◽  
Vol 49 (5) ◽  
pp. 711-724 ◽  
Author(s):  
Kunihiko Osaka ◽  
Takashi Tanimura ◽  
Akihiko Hirayama ◽  
Satoshi Matsumoto
Keyword(s):  
Spinal Cord ◽  
Chiari Malformation ◽  
Cervical Cord ◽  
Human Embryos ◽  
Content Type ◽  
Fetal Period ◽  
Arnold Chiari Malformation ◽  
Spina Bifida Cystica ◽  
Almost All ◽  
Fine Print

✓ The authors report a study of 92 human embryos and four fetuses with myeloschisis. The characteristics of embryonic myeloschisis compared with spina bifida cystica in infants are: 1) the lesion is often more diffuse, involving the whole spinal cord (12 embryos); 2) the cervical cord is more frequently affected (23 of the remaining 80 embryos); 3) holoprosencephaly is frequently associated (18 embryos); 4) meningocele is not found; and 5) hydrocephalus and Arnold-Chiari malformation are not yet developed. Hydrocephalus and Arnold-Chiari malformation are found in myeloschistic fetuses. Almost all embryos with diffuse and cervical myeloschisis or with holoprosencephaly are extruded before birth by spontaneous abortion. Absence of meningocele in the embryonic period implies that its appearance is deferred to the fetal period. The development of hydrocephalus and Arnold-Chiari malformation also seems to be delayed until the fetal period. Our observation implies that myelomeningocele is induced by non-closure of the neural tube, not by rupture once it was closed. “Neural overgrowth” and disturbed “recanalization process” are discussed in relation to the pathogenesis of myelomeningocele.

Malignant hyperthermia

1977 ◽  
Vol 46 (3) ◽  
pp. 385-390 ◽  
Author(s):  
Jeffery L. Rush ◽  
Eldon L. Foltz
Keyword(s):  
Metabolic Acidosis ◽  
Malignant Hyperthermia ◽  
Chiari Malformation ◽  
Tissue Hypoxia ◽  
Content Type ◽  
Arnold Chiari Malformation ◽  
Noncommunicating Hydrocephalus ◽  
Unusual Problem ◽  
Fine Print

✓ The authors report the case of an infant with noncommunicating hydrocephalus, Arnold-Chiari malformation, and a lumbar myelomeningocele, in whom malignant hyperthermia occurred. The genetics and presumed etiology of this unusual problem are reviewed. The management is directed toward establishing effective cooling measures, reversing tissue hypoxia, and correcting respiratory and metabolic acidosis.

The relationship of Arnold-Chiari and Dandy-Walker malformations

1972 ◽  
Vol 36 (4) ◽  
pp. 481-486 ◽  
Author(s):  
W. James Gardner ◽  
J. Lawton Smith ◽  
Dorcas H. Padget
Keyword(s):  
Posterior Fossa ◽  
Chiari Malformation ◽  
Content Type ◽  
Arnold Chiari Malformation ◽  
Dandy Walker Malformation ◽  
Walker Malformation ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ The posterior fossa is abnormally small in cases of Arnold-Chiari malformation because the tentorium is too low, whereas it is abnormally large in the Dandy-Walker malformation because the tentorium is too high.

Unusual causes of trigeminal neuralgia treated by gamma knife radiosurgery

2002 ◽  
Vol 97 ◽  
pp. 533-535 ◽  
Author(s):  
Jin Woo Chang ◽  
Jae Young Choi ◽  
Young Sul Yoon ◽  
Yong Gou Park ◽  
Sang Sup Chung
Keyword(s):  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Fourth Ventricle ◽  
Gamma Knife Radiosurgery ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Segmental Demyelination ◽  
Content Type ◽  
Clinical Responses ◽  
Fine Print

✓ The purpose of this paper was to present two cases of secondary trigeminal neuralgia (TN) with an unusual origin and lesion location. In two cases TN was caused by lesions along the course of the trigeminal nerve within the pons and adjacent to the fourth ventricle. Both cases presented with typical TN. Brain magnetic resonance imaging revealed linear or wedge-shaped lesions adjacent to the fourth ventricle, extending anterolaterally and lying along the pathway of the intraaxial trigeminal fibers. The involvement of the nucleus of the spinal trigeminal tract and of the principal sensory trigeminal nucleus with segmental demyelination are suggested as possible causes for trigeminal pain in these cases. It is postulated that these lesions are the result of an old viral neuritis. The patients underwent gamma knife radiosurgery and their clinical responses have been encouraging to date.

Teratoma of the fourth ventricle

1973 ◽  
Vol 38 (3) ◽  
pp. 355-357 ◽  
Author(s):  
Robert J. Morelli
Keyword(s):  
Fourth Ventricle ◽  
Rare Case ◽  
Surgical Removal ◽  
Malignant Teratoma ◽  
Content Type ◽  
Fine Print

✓ The author reports a rare case in which a primary malignant teratoma presented as an obstructing mass in the fourth ventricle. The tumor was not cystic but well encapsulated, and a gross total surgical removal was accomplished. A fatal recurrence occurred within 3 months.

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