ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2019
Management of Chiari I malformation in children: personal opinions.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- The management of Chiari malformation type 1 and syringomyelia in children: a review of the literature.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Pooled it
- Apert syndrome: neurosurgical outcomes and complications following posterior vault distraction osteogenesis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Management of Chiari I malformations: a paradigm in evolution.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2019Review
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2 authors at 1 institution in 1 country.
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Abstract
purposeThis manuscript describes our management philosophy of Chiari I malformation in children based on a single neurosurgeon's personal experience.
methodsBased on 61 infants and children with Chiari I malformation treated from 2007 to 2017, typical symptoms, surgical indications, types of surgery, and evaluation of surgical decompression are reviewed.
resultsSixty-one patients had 69 decompressions, with 90% having symptom improvement. Seven (11.5%) needed reoperation, 1 of which needed 2 reoperations for recurrence. The recurrence rates were 20% (5 of 25) after dural scoring and 5.6% (2 of 36) after duraplasty (p = 0.1116, Fisher's exact test). Six (16%) of 36 patients developed pseudomeningocele or CSF leak.
conclusionsWe recommend surgical intervention for Chiari I malformation for clearly symptomatic patients and those with significant hydromyelia regardless of symptoms. A bony decompression with dural scoring is recommended for patients with typical occipital headaches with a lesser degree of tonsillar descent, while an expansile duraplasty is standard for those with high-grade tonsillar descent, medullary kink, or hydromyelia. Intraoperative ultrasound is often helpful to ensure the adequacy of the decompression. Most patients will have improvements in symptom and imaging after either type of decompressive surgery.
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