Arnold-Chiari Deformity in an Adult Without Obvious Cause

Bucy, Paul C.; Lichtenstein, Ben W.

doi:10.3171/jns.1945.2.3.0245

Cited by 33 publications

(12 citation statements)

References 8 publications

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“…Also many publications (1,5,15,22,26,35,45,57,59) claiming Arnold-Chiari deformities without the presence of occipital bone and spine abnormalities, are in fact not proven Arnold-Chiari, but possible Chiari type I deformities. Only PEACH'S recent publication is probably the first proven Arnold-Chiari deformity without spinal dysraphism.…”

Section: Discussionmentioning

confidence: 99%

Skull Abnormalities Associated with the Arnold Chiari Malformation

Kruyff¹,

Jeffs²

1966

Acta Radiologica. Diagnosis

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Children with a spina bifida often present signs and symptoms of bladder dysfunction -neurogenic bladder. It is also known that meningo-myeloceles are frequently associated with the so-called Arnold-Chiari deformity of the hindbrain. It seemed of interest to investigate whether a radiologically demonstrable correlation between the spina bifida and possible skull abnormalities existed in these children.Material. In a period of 11 months, 93 patients with a neurogenic bladder were sent for routine urography, to which was added routine skull radiography. Thirteen of them with a history of tumor of or trauma to the spinal cord were excluded from the series (their skull films were normal). Eighty patients had a meningomyelocele; their ages ranged from 1 to 16 years (Fig. 1) and these are our concern in this study.Spinal defects, widening of the spinal canal and neural arch defects were constantly present, but to a variable degree and location (Fig. 2); 25 % had spinal dysraphism only in the sacral, or only in the lumbar area, while the majority had involvement of more than one segment of the spine. Diastema-9 by guest on July 24, 2015 acr.sagepub.com Downloaded from

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Section: Discussionmentioning

confidence: 99%

Skull Abnormalities Associated with the Arnold Chiari Malformation

Kruyff¹,

Jeffs²

1966

Acta Radiologica. Diagnosis

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“…Cerebellar herniation through the foramen magnum may be found in patients with or without craniovertebral anomalies and meningomyeloceles. In association with craniovertebral abnormalities in adult patients it has been observed by Chamberlain (1939), Gustafson and Oldberg (1940), List (1941), Craig, Walsh, and Camp (1942), Scoville and Sherman (1951) Garcin and Oeconomos (1953), Cogan and Barrows (1954), and by others. With a normal craniovertebral junction it has been reported by Aring (1938), McConnell and Parker (1938), Ogryzlo ( 1942), Bucy and Lichtenstein (1945), Gardner and Goodall (1950), and by others.…”

Section: Commentarymentioning

confidence: 86%

Lumbosacral Spina Bifida Cystica With Craniovertebral Anomalies: Report of Two Cases Presenting With Neurological Disorder in Adult Life

Spillane¹,

Rogers²

1959

Journal of Neurology, Neurosurgery & Psychiatry

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“…The use of SSEP and BAER as a real-time, intraoperative surrogate for surgical outcome or extent of decompression in Chiari type I malformation has been proposed, but not proven. The purpose of suboccipital craniectomy itself remains debatable, with various authors asserting relief of direct compression on neural structures,[1346152328] improvements in CSF flow,[3101522232528] decompression of vascular structures,[23] and/or creation of a cisterna magna,[1517] as principal objectives of the procedure. However, our study and others have shown that the neurophysiological parameters consistently improve following decompression.…”

Section: Discussionmentioning

confidence: 99%

Suboccipital craniotomy for Chiari I results in evoked potential conduction changes

Chen¹,

Coutin-Churchman²,

Nuwer³

et al. 2012

Surg Neurol Int

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Background:Management of Chiari I is controversial, in part because there is no widely used quantitative measurement of decompression. It has been demonstrated that brainstem auditory evoked responses (BAER) and somatosensory evoked potentials (SSEP) have decreased conduction latencies after wide craniectomy. We analyzed these parameters in a suboccipital craniectomy/craniotomy procedure.Methods:Thirteen consecutive patients underwent suboccipital decompression for treatment of symptomatic Chiari I. Craniectomy was restricted to the inferior aspect of the nuchal line, and in most cases the bone flap was replaced. Neuronal conduction was monitored continuously with median nerve somatosensory evoked potentials (M-SEP), posterior tibial nerve somatosensory evoked potentials (T-SEP), BAER, or a combination. The M-SEP N20, T-SEP P37, and BAER V latencies were recorded at four milestones – preoperatively, following craniotomy, following durotomy, and following closure.Results:Five males and eight females, with average age of 9 years, were studied. Clinical improvement was noted in all 13 patients. M-SEP N20 latency decreased from a mean of 18.55 at baseline to 17.75 ms after craniotomy (P = 0.01); to 17.06 ms after durotomy (P = 0.01); and to 16.68 ms after closing (P = 0.02). T-SEP P37 latency did not change significantly. BAER V latency decreased from a mean of 6.25 ms at baseline to 6.14 ms after craniotomy (P = 0.04); to 5.98 ms after durotomy (P = 0.01); and to 5.95 ms after closing (P = 0.45).Conclusion:Significant improvements in conduction followed both craniectomy and durotomy. Bone replacement did not affect these results.

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Arnold-Chiari Deformity in an Adult Without Obvious Cause

Cited by 33 publications

References 8 publications

Skull Abnormalities Associated with the Arnold Chiari Malformation

Skull Abnormalities Associated with the Arnold Chiari Malformation

Lumbosacral Spina Bifida Cystica With Craniovertebral Anomalies: Report of Two Cases Presenting With Neurological Disorder in Adult Life

Suboccipital craniotomy for Chiari I results in evoked potential conduction changes

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