Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr-Jun;65(2-3):69-74.
doi: 10.1016/j.neuchi.2018.10.010. Epub 2019 Feb 8.

Chiari malformations in adults: A single center surgical experience with special emphasis on the kinetics of clinical improvement

S Y Elhadji Cheikh Ndiaye  1 , L Troude  2 , M Al-Falasi  2 , M Faye  3 , A Melot  2 , P-H Roche  2
Affiliations

Chiari malformations in adults: A single center surgical experience with special emphasis on the kinetics of clinical improvement

S Y Elhadji Cheikh Ndiaye et al. Neurochirurgie. 2019 Apr-Jun.

Abstract

Background: The Chiari malformation type I (CM-I) is the most commonly found type in adults. The efforts to further improve the treatment offered for these malformations are hampered by the existence of controversial methods and the absence of a uniform scoring system to evaluate clinical outcomes.

Objectives: The goal of our study is to analyze the clinical and radiological data concerning patients operated for CM and to expose surgical techniques.

Patients and treatment: This is a retrospective study concerning patients of more than 16 years of age, operated on (from 2000 to 2016) in our institution. These patients underwent bony decompression of the cervico-occipital junction, with a duraplasty enlargement. Clinical and radiological follow-up was assessed sequentially.

Results: The mean age of patients included in this study was 39. Headaches (n=19) and sensory disturbances (n=17) were the most common presenting complaints. Furthermore, syringomyelia symptoms were present in 34.5% of the cases (n=10). Twenty-three patients displayed a Chiari malformation of type I (79.3%), and six patients were classified as Chiari malformation type I.5 (20.7%). A syringomyelia was present in 58.6% of the cases (n=17). The postoperative complications that were encountered were: one case of pseudo-meningocele, two cases of cerebrospinal fluid leakage, two cases of meningitis, and one case of delayed wound healing. The mean follow-up period was 18 months, which showed beneficial outcomes in 82.8% of the cases (20.7% cured, and 62.1% improved) and an unfavorable outcome in 17.2% of the cases (13.8% stable patients and 3.4% worsened outcomes). Syringomyelia symptoms were improved in 60% of the patients. Among the patients who presented without a syrinx, 82.3% had good outcomes; and those who presented with a syrinx, 83.4% had good outcomes. Symptoms improved for 69% of patients within 3 months.

Conclusion: An optimal craniocervical osteo-dural decompression plus duraplasty offered early and sustainable good clinical results in symptomatic CM-I and CM-I.5 patients.

Keywords: Chiari malformation; Occipito-cervical decompression - Syringomyelia.

PubMed Disclaimer