Relevance of surgical strategies for the management of pediatric Chiari type I malformation

Galarza, Marcelo; Sood, Sandeep; Ham, Steven
June 2007
Child's Nervous System;Jun2007, Vol. 23 Issue 6, p691
Academic Journal
Objective In face of continuing controversy to the optimal treatment of Chiari type I malformation, the authors analyzed three different surgical strategies. Materials and methods Sixty patients (30 boys and 30 girls, mean age 8.2 years) presented with clinical Chiari malformation. Additional syringomyelia was present in 24 children, whereas cine flow studies showed no flow in the craniocervical junction in 48 children. All patients underwent a limited occipital craniectomy; a duraplasty was performed in 21 cases; and additional tonsillar reduction was performed in 19 cases. Clinical improvement was seen in 24 patients who underwent posterior decompression with or without duraplasty. In the tonsillar group, clinical improvement was evident in 18 patients. Conclusions Duraplasty and tonsillar reduction were equally effective but significantly better than bone decompression alone. Among patients with syringomyelia, tonsillar reduction was associated with a significantly better outcome. Postoperative flow studies improved in 39 patients but did not correlate to the clinical outcome.


Related Articles

  • Cognitive and functional outcome in spina bifida-Chiari II malformation. Jenkinson, Michael D.; Campbell, Sophie; Hayhurst, Caroline; Clark, Simon; Kandasamy, Jothy; Lee, Maggie K.; Flynn, Ann; Murphy, Peter; Mallucci, Conor L. // Child's Nervous System;Jun2011, Vol. 27 Issue 6, p967 

    Purpose: The long-term outcome in spina bifida-Chiari II-hydrocephalus complex is poorly understood. Traditional neurosurgical outcome measures are crude. Neuropsychological testing is increasingly important in outcome assessment. We investigated the health, disability, lifestyle and cognitive...

  • Surgical Treatment of Calcaneal Deformity in a Select Group of Patients with Myelomeningocele. Kun Bo Park; Hui Wan Park; Sun Young Joo; Hyun Woo Kim // Journal of Bone & Joint Surgery, American Volume;Oct2008, Vol. 90-A Issue 10, p2149 

    Background: The surgical treatment of calcaneal deformity in patients with myelomeningocele has not been uniformly successful in correcting the deformity and preventing recurrence. The purpose of the present study was to examine the results of posterior transfer of the anterior tibial tendon...

  • Biologic Characteristics of Fibrous Hamartoma from Congenital Pseudarthrosis of the Tibia Associated with Neurofibromatosis Type 1. Tae-Joon Cho; Joong-Bae Seo; Hye Ran Lee; Won Joon Yoo; Chin Youb Chung; In Ho Choi // Journal of Bone & Joint Surgery, American Volume;Dec2008, Vol. 90-A Issue 12, p2735 

    Background: Fibrous hamartoma is a key pathologic component of congenital pseudarthrosis of the tibia, a challenging and disabling bone disorder. We investigated the biologic characteristics of fibrous hamartoma cells in order to better understand the pathogenesis of this rare disease. Methods:...

  • The Role of Pantalar Arthrodesis in the Treatment of Paralytic Foot Deformities. Provelengios, Stefanos; Papavasiliou, Kyriakos A.; Kyrkos, Margaritis J.; Kirkos, John M.; Kapetanos, George A. // Journal of Bone & Joint Surgery, American Volume;Mar2009, Vol. 91-A Issue 3, p575 

    Background: Pantalar arthrodesis is considered by many to be the final operative option before amputation for the treatment of paralytic foot deformities. The aim of the present study was to evaluate the long-term results of pantalar arthrodesis with regard to its impact on the adjacent joints...

  • Effectiveness of Groups for Adolescents With Type 1 Diabetes Mellitus and Their Parents. Kichler, Jessica C.; Marik, Patricia; Kaugars, Astrida S.; Nabors, Laura; Alemzadeh, Ramin // Families, Systems & Health: The Journal of Collaborative Family ;Sep2013, Vol. 31 Issue 3, p280 

    Peer- and family-based group therapies have been used as separate interventions to improve adjustment and self-management among youth with Type 1 diabetes mellitus. This study replicates a treatment protocol that combined these two types of diabetes management groups, while also using a...

  • Effect of Korean red ginseng on insulin sensitivity in non-diabetic healthy overweight and obese adults. Young Hye Cho; Soon Cheol Ahn; Sang Yeoup Lee; Dong Wook Jeong; Eun Jung Choi; Yun Jin Kim; Jeong Gyu Lee; Yu-Hyun Lee; Byung-Cheul Shin // Asia Pacific Journal of Clinical Nutrition;Sep2013, Vol. 22 Issue 3, p365 

    Background: Korean red ginseng is one of the most popular herbs worldwide due to the belief that it contains ingredients that possess a variety of health enhancing effects including anti-diabetic effects. The objective of this study was to determine whether Korean red ginseng supplement has an...

  • Therapeutics: Randomised controlled trial: Prophylactic paracetamol at the time of infant vaccination reduces the risk of fever, but also reduces antibody response. Yalçin, S. Songül; Yalçin, S. Songü // Evidence Based Nursing;Jul2010, Vol. 13 Issue 3, p76 

    No abstract available.

  • Alternativas para el tratamiento de hipoplasias maxilares. Meneses, Dora; Botero, Paola // CES Odontología;2012, Vol. 25 Issue 1, p64 

    Class III skeletal malocclusion due to maxillary hypoplasia, compromises esthetics and functional aspects of patients. Different types of treatment have been developed depending on the severity of the deformity. Patients with severe maxillary hypoplasia and those with craniofacial abnormalities...

  • Treatment of Refractory Dry Eye Associated with Graft Versus Host Disease with 0.03% Tacrolimus Eyedrops. Sanz-Marco, Empar; Udaondo, Patricia; García-Delpech, Salvador; Vazquez, Amparo; Diaz-Llopis, Manuel // Journal of Ocular Pharmacology & Therapeutics;Oct2013, Vol. 29 Issue 8, p776 

    Purpose: We investigate the efficacy of 0.03% topical tacrolimus eyedrops for the treatment of dry eye in graft versus host disease (GVHD) patients resistant/intolerant to 0.05% topical cyclosporine. Methods: Forty-three patients were enrolled in this prospective study. After completing a 1-year...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics