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Endoscopic third ventriculostomy for treatment of noncommunicating syringomyelia associated with a Chiari I malformation and hydrocephalus: case report and pathophysiological considerations.
Neurosurgery. 2002 Aug; 51(2):500-3; discussion 503-4.N

Abstract

OBJECTIVE AND IMPORTANCE

A Chiari I malformation associated with syringomyelia and hydrocephalus is a rare condition. We report the successful use of endoscopic third ventriculostomy for the treatment of this pathological entity. The successful use of this technique in such a case has not been previously described, and the results allow us to speculate on the pathophysiological mechanism involved.

CLINICAL PRESENTATION

A 34-year-old woman presented with headaches, a motor deficit of the right upper limb, and gait dyspraxia. Magnetic resonance imaging scans demonstrated dilation of all ventricles, compression of the retrocerebellar cerebrospinal fluid space, downward displacement of the tonsils, and syringomyelia. Syringomyelia involved the cervicodorsal cord below C3, with a syrinx-free segment between C1 and C3 and no enlargement of the rostral part of the central canal.

INTERVENTION

Endoscopic third ventriculostomy resulted in prompt improvement of the clinical symptoms. Postoperative magnetic resonance imaging scans demonstrated shrinkage of the syrinx and return of the cerebellar tonsils to their physiological positions.

CONCLUSION

This experience demonstrates that endoscopic third ventriculostomy, which is a simple, safe technique, may be the treatment of choice for associated Chiari I malformations, hydrocephalus, and syringomyelia (even the noncommunicating type).

Authors+Show Affiliations

Department of Neurosurgery, Timone Hospital, Marseille, France. p.metellus@libertysurf.frNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

12182791

Citation

Métellus, Philippe, et al. "Endoscopic Third Ventriculostomy for Treatment of Noncommunicating Syringomyelia Associated With a Chiari I Malformation and Hydrocephalus: Case Report and Pathophysiological Considerations." Neurosurgery, vol. 51, no. 2, 2002, pp. 500-3; discussion 503-4.
Métellus P, Dufour H, Levrier O, et al. Endoscopic third ventriculostomy for treatment of noncommunicating syringomyelia associated with a Chiari I malformation and hydrocephalus: case report and pathophysiological considerations. Neurosurgery. 2002;51(2):500-3; discussion 503-4.
Métellus, P., Dufour, H., Levrier, O., & Grisoli, F. (2002). Endoscopic third ventriculostomy for treatment of noncommunicating syringomyelia associated with a Chiari I malformation and hydrocephalus: case report and pathophysiological considerations. Neurosurgery, 51(2), 500-3; discussion 503-4.
Métellus P, et al. Endoscopic Third Ventriculostomy for Treatment of Noncommunicating Syringomyelia Associated With a Chiari I Malformation and Hydrocephalus: Case Report and Pathophysiological Considerations. Neurosurgery. 2002;51(2):500-3; discussion 503-4. PubMed PMID: 12182791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic third ventriculostomy for treatment of noncommunicating syringomyelia associated with a Chiari I malformation and hydrocephalus: case report and pathophysiological considerations. AU - Métellus,Philippe, AU - Dufour,Henry, AU - Levrier,Olivier, AU - Grisoli,François, PY - 2001/10/24/received PY - 2002/04/08/accepted PY - 2002/8/17/pubmed PY - 2002/10/11/medline PY - 2002/8/17/entrez SP - 500-3; discussion 503-4 JF - Neurosurgery JO - Neurosurgery VL - 51 IS - 2 N2 - OBJECTIVE AND IMPORTANCE: A Chiari I malformation associated with syringomyelia and hydrocephalus is a rare condition. We report the successful use of endoscopic third ventriculostomy for the treatment of this pathological entity. The successful use of this technique in such a case has not been previously described, and the results allow us to speculate on the pathophysiological mechanism involved. CLINICAL PRESENTATION: A 34-year-old woman presented with headaches, a motor deficit of the right upper limb, and gait dyspraxia. Magnetic resonance imaging scans demonstrated dilation of all ventricles, compression of the retrocerebellar cerebrospinal fluid space, downward displacement of the tonsils, and syringomyelia. Syringomyelia involved the cervicodorsal cord below C3, with a syrinx-free segment between C1 and C3 and no enlargement of the rostral part of the central canal. INTERVENTION: Endoscopic third ventriculostomy resulted in prompt improvement of the clinical symptoms. Postoperative magnetic resonance imaging scans demonstrated shrinkage of the syrinx and return of the cerebellar tonsils to their physiological positions. CONCLUSION: This experience demonstrates that endoscopic third ventriculostomy, which is a simple, safe technique, may be the treatment of choice for associated Chiari I malformations, hydrocephalus, and syringomyelia (even the noncommunicating type). SN - 0148-396X UR - https://www.unboundmedicine.com/medline/citation/12182791/Endoscopic_third_ventriculostomy_for_treatment_of_noncommunicating_syringomyelia_associated_with_a_Chiari_I_malformation_and_hydrocephalus:_case_report_and_pathophysiological_considerations_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=12182791.ui DB - PRIME DP - Unbound Medicine ER -