Chiari I: Surgery

 

Perrini P, Rawlinson A, Cowie RA, King AT.

Acute external hydrocephalus complicating craniocervical decompression for syringomyelia-Chiari I complex : Case report and review of the literature.

Neurosurg Rev. 2008 Mar 1.


  1. BulletThe arachnoid membrane is frequently opened during a posterior fossa decompression for Chiari malformation - just as it is for any operation on the brain. Most often, spinal fluid stays in its space - inside the arachnoid. However, in a few rare cases, spinal fluid finds its way between the dura membrane and arachnoid membrane and becomes trapped. In this case, the collections were large enough to require treatment with a shunt.



Hayhurst C, Richards O, Zaki H, Findlay G, Pigott TJ.

Hindbrain decompression for Chiari - syringomyelia complex: an outcome analysis comparing surgical techniques.

Br J Neurosurg. 2008 Feb;22(1):86-91.


  1. BulletA retrospective study of patients treated from 1994 to 2005. While helpful, prospective studies are needed.



Belen D, Er U, Gurses L, Yigitkanli K.

Delayed pseudomyelomeningocele: a rare complication after foramen magnum decompression for Chiari malformation.

Surg Neurol. 2008 Jan 18


  1. BulletIn Chiari decompression with dural opening, most neurosurgeons perform a duraplasty. However, some do not. Rarely, the tonsils herniate through the dural opening and become scarred. Belen et al. report the first case of herniation of the spinal cord through the surgical dural defect.

    A 22-year-old man, having undergone a posterior fossa decompression without duraplasty 7 years previously, presented with progressive spinal cord compression. MRI revealed a     "pseudomyelomeningocele at C1 level together with cord distortion." A microsurgical untethering operation with duraplasty was required and moderate improvement was noted in the early post-operative period. 



Al-Otibi M, Jea A, Kulkarni AV.

Detection of important venous collaterals by computed tomography venogram in multisutural synostosis. Case report and review of the literature.

J Neurosurg. 2007 Dec;107(6 Suppl):508-10


Bejjani GK, Zabramski J; Durasis Study Group.
Safety and efficacy of the porcine small intestinal submucosa dural substitute: results of a prospective multicenter study and literature review.
J Neurosurg. 2007 Jun;106(6):1028-33. 

Blackburn SL, Smyth MD.
Hydrogel-induced cervicomedullary compression after posterior fossa decompression for Chiari malformation. Case report.
J Neurosurg. 2007 Apr;106(4 Suppl):302-4.


Caldarelli M, Novegno F, Vassimi L, Romani R, Tamburrini G, Di Rocco C.
The role of limited posterior fossa craniectomy in the surgical treatment of Chiari malformation Type I: experience with a pediatric series.
J Neurosurg. 2007 Mar;106(3 Suppl):187-95. 


Yeh DD, Koch B, Crone KR.
Intraoperative ultrasonography used to determine the extent of surgery necessary during posterior fossa decompression in children with Chiari malformation type I.
J Neurosurg. 2006 Jul;105(1 Suppl):26-32. 


Limonadi FM, Selden NR.
Dura-splitting decompression of the craniocervical junction: reduced operative time, hospital stay, and cost with equivalent early outcome.
J Neurosurg. 2004 Nov;101(2 Suppl):184-8. 


Rosen DS, Wollman R, Frim DM.
Recurrence of symptoms after Chiari decompression and duraplasty with nonautologous graft material.
Pediatr Neurosurg. 2003 Apr;38(4):186-90.