scholarly journals Somatosensory evoked potentials and cerebrospinal fluid flow in chiari malformation

2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Gonul Guvenc
2020 ◽  
pp. 219256822094529
Author(s):  
Ali Arslan ◽  
Semih Kivanc Olguner ◽  
Vedat Acik ◽  
İsmail İstemen ◽  
Barış Arslan ◽  
...  

Study Design: Retrospective chart review. Objectives: Chiari malformation (CM) is characterized by a downward displacement of the cerebellar tonsils through the foramen magnum. This tonsillar herniation may sometimes be accompanied by syringomyelia and/or basilar invagination (BI). In this study, we examined the surgical outcomes of patients by underwent C1-2 reduction + fixation (C1-2RF), which is a new method defined by Goel, in the literature. Methods: Between 2015 and 2018, 21 patients (mean age and duration of follow-up: 39 years and 20 months, respectively) with CM were treated with atlantoaxial fixation. We found syringomyelia in all patients and BI in 9 of them. In all cases, radiography, computed tomography, and magnetic resonance imaging were performed radiologically. C1-2RF was performed in all patients. Preoperative and postoperative clinical Japanese Orthopaedic Association scores were obtained. Syrinx size and cerebrospinal fluid flow rate were compared radiologically. Results: All patients were treated with C1-2RF. None of the patients underwent foramen magnum decompression or intervention for the syrinx. Occipital bone and subaxial spinal structures were not included in the fixation. In addition to significant clinical improvement, significant improvement in syringomyelia and cerebrospinal fluid flow rate was seen on the radiographs of all patients. Conclusions: Although posterior fossa decompression and/or duraplasty is a common treatment modality in CM, we propose that the C1-2RF method described by Goel is a radiologically and clinically effective treatment method, whether or not BI and/or syringomyelia in CM are present. This article is the first article of central and axial atlantoaxial dislocation, except for Goel’s writings in the literature.


2008 ◽  
Vol 25 (6) ◽  
pp. E12 ◽  
Author(s):  
Xiao Di ◽  
Mark G. Luciano ◽  
Edward C. Benzel

Cerebellar ptosis is a rare complication following Chiari malformation decompression, and generally is the result of a very large suboccipital craniectomy. This can lead to the descent of the cerebellum through the craniectomy defect, which in turn may result in cerebellar herniation through the surgical defect as well as the reestablishment of contact between the cerebellar tonsils and the brainstem. In addition, dorsal adherence of the herniated cerebellum to the dura mater or dural patch and an associated obstruction of cerebrospinal fluid flow at the cervicomedullary junction may ensue. Such a result is not desirable, in that it reproduces or mimics the pathoanatomical relationships that existed prior to the surgical decompression.


Neurosurgery ◽  
1991 ◽  
Vol 28 (6) ◽  
pp. 883-885 ◽  
Author(s):  
Teiji Tominaga ◽  
Keiji Koshu ◽  
Akira Ogawa ◽  
Takashi Yoshimoto

Abstract Cine-mode magnetic resonance imaging provides simultaneous images of cerebrospinal fluid flow dynamics. A patient with a basilar impression accompanied by a Chiari malformation and von Recklinghausen's disease who underwent transoral decompression is reported. Preoperative cine-mode magnetic resonance imaging visualized an associated obstruction of cerebrospinal fluid pulsatile flow at the level of the foramen magnum. Tonsilar herniation (Chiari I malformation) and hydrocephalus were also present. Postoperatively, the obstruction of cerebrospinal fluid flow was resolved concomitant with the correction of the cervicomedullary angulation. On the basis of observations made by magnetic resonance imaging, the surgical treatment of basilar impression accompanied by Chiari malformation is briefly discussed.


Author(s):  
Emilie W. Olstad ◽  
Christa Ringers ◽  
Adinda Wens ◽  
Jan N. Hansen ◽  
Cecilia Brandt ◽  
...  

Author(s):  
Mostafa Eltobgy ◽  
Kristin Huntoon ◽  
Nick Musgrave ◽  
Ammar Shaikhouni ◽  
Douglas A. Hardesty ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document