Malformation d’Arnold Chiari de type II et impression basilaire.À propos d’un cas (revue de la littérature)

Thiébaut, Michel; Bigot, P. Le; Besson, Gérard; Dorval, Metig; Martin, C

doi:10.1016/s0168-6054(02)00188-5

Cited by 2 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In adulthood, some of these patients can have recurrence of cervicomedullary dysfunction from a combination of basilar invagination, ventral compression from a dorsally inclined odontoid and posterior cervical bony regrowth [4,5]. Often these patients are treated with transoral-transpharyngeal odontoid resection.…”

Section: Background/aimsmentioning

confidence: 99%

Aggressive Surgical Management of Patients with Chiari II Malformation and Brainstem Dysfunction

Rahman¹,

Perkins²,

Pincus³

2009

Pediatr Neurosurg

View full text Add to dashboard Cite

Background/Aims: Chiari II malformation represents a group of developmental abnormalities involving the caudal displacement of the cervicomedullary junction, pons, fourth ventricle, and medulla. This constellation of malformations is strongly associated with myelomeningocele (MM) and is a known cause of neurologic deterioration in older MM patients. We describe the evaluation and management of 4 adult MM patients who presented with brainstem compression and a retroflexed odontoid who were subject to aggressive surgical management including occipitocervical (OC) fusion with good clinical results. Methods: Four MM patients who underwent OC fusion for new-onset brainstem dysfunction and myelopathy were identified in the practice of the principal investigator (D.W.P.) from 2003 to 2008. Results: The initial evaluation of these patients included consideration of other diagnoses, such as hydrocephalus due to shunt malfunction and tethered cord. These patients were treated with aggressive surgical management. In some cases, multiple surgeries were performed. All 4 patients were treated with cervical decompression and OC fixation and initially had good outcomes. No patients required transoral decompression. Three of the 4 had stable improvement at their last follow-up appointment (mean follow-up of 9 months). Conclusion: Late deterioration in older MM patients may be secondary to brainstem or cervical spinal cord compression from ventral odontoid compression and Chiari II malformation, hydrocephalus, hydromyelia, or tethered cord. These patients may benefit from more than one surgery. Posterior decompression and OC fusion can avoid a morbid transoral odontoid resection, greatly improve patients’ symptoms and prevent further neurologic decline.

show abstract

Section: Background/aimsmentioning

confidence: 99%

Aggressive Surgical Management of Patients with Chiari II Malformation and Brainstem Dysfunction

Rahman¹,

Perkins²,

Pincus³

2009

Pediatr Neurosurg

View full text Add to dashboard Cite

show abstract

“…The differential diagnosis is with a CM-I (no MMC) and an isolated MMC without anomaly of the posterior cranial fossa. 4 The clinic is mainly associated with the compression mechanism of damage to the nervous structures and impaired hemolytic dynamics. In this case, intracranial hypertension and hydrocephalus develop.…”

Section: Introductionmentioning

confidence: 99%

“…The differential diagnosis is with a CM-I (no MMC) and an isolated MMC without anomaly of the posterior cranial fossa. 4 …”

Section: Introductionmentioning

confidence: 99%

Hundred Pediatric Cases Treated for Chiari Type II Malformation with Hydrocephalus and Myelomeningocele

et al. 2023

View full text Add to dashboard Cite

Background Chiari malformation type II (CM-II) may not always present as an asymptomatic disorder but prove to be difficult in managing. This is especially true for neonates who show the worst prognosis. There is confounding data over whether shunting or craniocervical junction (CVJ) decompression should be employed. This retrospective analysis summarizes the results of 100 patients diagnosed and treated for CM-II along with hydrocephalus and myelomeningocele. Methods We reviewed all the children who were diagnosed and surgically treated for CM-II at the Moscow Regional Hospital. Surgical timing was decided on the clinical conditions of each patient. Urgent surgery in the more compromised patients (usually infants) and elective surgery for patients with less severe conditions was performed. All patients first underwent CVJ decompression. Results The retrospective review yielded 100 patients operated on for CM-II with concomitant hydrocephalus and myelomeningocele. The average herniation was 11.2 ± 5.1 mm. However, herniation level did not correlate with clinical findings. Concomitant syringomyelia was observed in 60% of patients. More severe spinal deformity was observed in patients with widespread syringomyelia (p = 0.04). In children of the younger age group, cerebellar symptoms and bulbar disorders were more frequently observed (p = 0.03), and cephalic syndrome was noted much less frequently (p = 0.005). The severity of scoliotic deformity correlated with the prevalence of syringomyelia (p = 0.03). Satisfactory results were significantly more often observed in patients of the older age group (p = 0.02). Patients with unsatisfactory results at the time of treatment were significantly younger (p = 0.02). Conclusion If CM-II is asymptomatic, then no specific treatment is prescribed. If the patient develops pain in the occiput and neck, then pain relievers are prescribed. If a patient has neurological disorders or concomitant syringomyelia, hydrocephalus or myelomeningocele, surgical intervention is indicated. The operation is also performed if the pain syndrome cannot be overcome within the framework of conservative therapy.

show abstract

Malformation d’Arnold Chiari de type II et impression basilaire.À propos d’un cas (revue de la littérature)

Cited by 2 publications

References 20 publications

Aggressive Surgical Management of Patients with Chiari II Malformation and Brainstem Dysfunction

Aggressive Surgical Management of Patients with Chiari II Malformation and Brainstem Dysfunction

Hundred Pediatric Cases Treated for Chiari Type II Malformation with Hydrocephalus and Myelomeningocele

Contact Info

Product

Resources

About