Tags

Type your tag names separated by a space and hit enter

Posterior fossa decompression with duraplasty in Chiari-1 malformations.
J Coll Physicians Surg Pak. 2015 Apr; 25(4):254-8.JC

Abstract

OBJECTIVE

To evaluate the symptomatic outcome after PFD (Posterior Fossa Decompression) with duraplasty in Chiari-1 malformations.

STUDY DESIGN

Case series.

PLACE AND DURATION OF STUDY

Department of Neurosurgery, JPMC, Karachi, from July 2008 to September 2012.

METHODOLOGY

This included 21 patients of Chiari 1 malformations admitted in department through OPD with clinical features of headache, neck pain, numbness, neurological deficit, and syringomyelia. Diagnosis was confirmed by MRI. PFD followed by C1 laminectomy with duraplasty was done in all cases and symptomatic outcome was assessed in follow-up clinic.

RESULTS

Among 21 patients, 13 were females and 8 were males. Age ranged from 18 to 40 years. All the patients had neck pain and numbness in hands. Only 3 patients had weakness of all four limbs and 12 with weakness of hands. Symptoms evolved over a mean of 12 months. Syringomyelia was present in all cases. All patients underwent posterior fossa decompression with duraplasty with an additional C1 laminectomy and in 2 cases C2 laminectomy was done. Syringo-subarachnoid shunt was placed in one patient and ventriculo-peritoneal shunt was placed in 2 patients. Pain was relieved in all cases. Weakness was improved in all cases and numbness was improved in 19 cases. Syringomyelia was improved in all cases. Postoperative complications included CSF leak in 2 patients and wound infection in one patient. However, there was no mortality.

CONCLUSION

Posterior fossa decompression with duraplasty is the best treatment option for Chiari-1 malformations because of symptomatic improvement and less chances of complications.

Authors+Show Affiliations

Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi.Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi.Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi.Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi.Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi.Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25899189

Citation

Rehman, Lal, et al. "Posterior Fossa Decompression With Duraplasty in Chiari-1 Malformations." Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, vol. 25, no. 4, 2015, pp. 254-8.
Rehman L, Akbar H, Bokhari I, et al. Posterior fossa decompression with duraplasty in Chiari-1 malformations. J Coll Physicians Surg Pak. 2015;25(4):254-8.
Rehman, L., Akbar, H., Bokhari, I., Babar, A. K., M Hashim, A. S., & Arain, S. H. (2015). Posterior fossa decompression with duraplasty in Chiari-1 malformations. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 25(4), 254-8. https://doi.org/04.2015/JCPSP.254258
Rehman L, et al. Posterior Fossa Decompression With Duraplasty in Chiari-1 Malformations. J Coll Physicians Surg Pak. 2015;25(4):254-8. PubMed PMID: 25899189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posterior fossa decompression with duraplasty in Chiari-1 malformations. AU - Rehman,Lal, AU - Akbar,Hamid, AU - Bokhari,Iram, AU - Babar,Asghar Khan, AU - M Hashim,A Sattar, AU - Arain,Safdar Hussain, PY - 2012/12/20/received PY - 2015/02/09/accepted PY - 2015/4/23/entrez PY - 2015/4/23/pubmed PY - 2015/11/18/medline SP - 254 EP - 8 JF - Journal of the College of Physicians and Surgeons--Pakistan : JCPSP JO - J Coll Physicians Surg Pak VL - 25 IS - 4 N2 - OBJECTIVE: To evaluate the symptomatic outcome after PFD (Posterior Fossa Decompression) with duraplasty in Chiari-1 malformations. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Department of Neurosurgery, JPMC, Karachi, from July 2008 to September 2012. METHODOLOGY: This included 21 patients of Chiari 1 malformations admitted in department through OPD with clinical features of headache, neck pain, numbness, neurological deficit, and syringomyelia. Diagnosis was confirmed by MRI. PFD followed by C1 laminectomy with duraplasty was done in all cases and symptomatic outcome was assessed in follow-up clinic. RESULTS: Among 21 patients, 13 were females and 8 were males. Age ranged from 18 to 40 years. All the patients had neck pain and numbness in hands. Only 3 patients had weakness of all four limbs and 12 with weakness of hands. Symptoms evolved over a mean of 12 months. Syringomyelia was present in all cases. All patients underwent posterior fossa decompression with duraplasty with an additional C1 laminectomy and in 2 cases C2 laminectomy was done. Syringo-subarachnoid shunt was placed in one patient and ventriculo-peritoneal shunt was placed in 2 patients. Pain was relieved in all cases. Weakness was improved in all cases and numbness was improved in 19 cases. Syringomyelia was improved in all cases. Postoperative complications included CSF leak in 2 patients and wound infection in one patient. However, there was no mortality. CONCLUSION: Posterior fossa decompression with duraplasty is the best treatment option for Chiari-1 malformations because of symptomatic improvement and less chances of complications. SN - 1681-7168 UR - https://www.unboundmedicine.com/medline/citation/25899189/Posterior_fossa_decompression_with_duraplasty_in_Chiari_1_malformations_ L2 - http://www.diseaseinfosearch.org/result/9550 DB - PRIME DP - Unbound Medicine ER -