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Craniometrical imaging and clinical findings of adult Chiari malformation type 1 before and after posterior fossa decompression surgery with duraplasty.
Br J Neurosurg. 2019 Oct; 33(5):481-485.BJ

Abstract

Background: Posterior fossa decompression both with and without duraplasty are accepted treatments for symptomatic adult patients with Chiari Malformations Type 1 (CM-1). There is still debate of the superiority of one technique over the other. The purpose of this study was to determine the clinical and craniometrical imaging outcomes of a series of patients who underwent posterior fossa decompression with duraplasty. Materials and methods: All adult patients with symptomatic CM-1 operated at a single institution with a minimum of 6 months follow-up were enrolled prospectively. Clinical outcomes and craniometrical parameters based upon MR imaging pre- and post-surgery were analyzed. Results: A series of 33 consecutive patients who met the inclusion criteria were enrolled; mean age of 33.93 ± 10 years (range 14-56 years). The most common preoperative complaint was headache. The most common clinical sign was sensory dysfunction which was relieved or improved in 63% of patients. The mean syringomyelia size had a significant reduction after the surgery (p = .01). The mean tonsillar descent also had significant reduction (p = .00). The mean McRae line length before the surgery and after that were 33.4 and 53.1 mm respectively that this change was not statistically significant (p = .42). The odontoid process parameters had no significant changes after surgery. Conclusions: Posterior fossa decompression surgery with duraplasty can improve both clinical and imaging outcomes such as syringomyelia size and tonsillar descent for patients with symptomatic CM-1. However, no significant difference was found in craniometrical parameters before and after the surgery.

Authors+Show Affiliations

Department of Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences , Tehran , Iran.Department of Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences , Tehran , Iran.Department of Neurosurgery, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania.Firoozgar Clinical Research and Development Center (FCRDC), Iran University of Medical Sciences , Tehran , Iran.Department of Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences , Tehran , Iran.Department of Neurosurgery, Rasoul-e-Akram Hospital, Iran University of Medical Sciences , Tehran , Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31096790

Citation

Nikoobakht, Mehdi, et al. "Craniometrical Imaging and Clinical Findings of Adult Chiari Malformation Type 1 Before and After Posterior Fossa Decompression Surgery With Duraplasty." British Journal of Neurosurgery, vol. 33, no. 5, 2019, pp. 481-485.
Nikoobakht M, Shojaei H, Gerszten PC, et al. Craniometrical imaging and clinical findings of adult Chiari malformation type 1 before and after posterior fossa decompression surgery with duraplasty. Br J Neurosurg. 2019;33(5):481-485.
Nikoobakht, M., Shojaei, H., Gerszten, P. C., Shojaei, S. F., Mollahoseini, R., & Azar, M. (2019). Craniometrical imaging and clinical findings of adult Chiari malformation type 1 before and after posterior fossa decompression surgery with duraplasty. British Journal of Neurosurgery, 33(5), 481-485. https://doi.org/10.1080/02688697.2019.1617407
Nikoobakht M, et al. Craniometrical Imaging and Clinical Findings of Adult Chiari Malformation Type 1 Before and After Posterior Fossa Decompression Surgery With Duraplasty. Br J Neurosurg. 2019;33(5):481-485. PubMed PMID: 31096790.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Craniometrical imaging and clinical findings of adult Chiari malformation type 1 before and after posterior fossa decompression surgery with duraplasty. AU - Nikoobakht,Mehdi, AU - Shojaei,Hamidreza, AU - Gerszten,Peter C, AU - Shojaei,Seyedeh Fahimeh, AU - Mollahoseini,Reza, AU - Azar,Maziar, Y1 - 2019/05/17/ PY - 2019/5/18/pubmed PY - 2019/12/31/medline PY - 2019/5/18/entrez KW - Chiari malformation KW - Decompression KW - Syringomyelia KW - cerebellar tonsil SP - 481 EP - 485 JF - British journal of neurosurgery JO - Br J Neurosurg VL - 33 IS - 5 N2 - Background: Posterior fossa decompression both with and without duraplasty are accepted treatments for symptomatic adult patients with Chiari Malformations Type 1 (CM-1). There is still debate of the superiority of one technique over the other. The purpose of this study was to determine the clinical and craniometrical imaging outcomes of a series of patients who underwent posterior fossa decompression with duraplasty. Materials and methods: All adult patients with symptomatic CM-1 operated at a single institution with a minimum of 6 months follow-up were enrolled prospectively. Clinical outcomes and craniometrical parameters based upon MR imaging pre- and post-surgery were analyzed. Results: A series of 33 consecutive patients who met the inclusion criteria were enrolled; mean age of 33.93 ± 10 years (range 14-56 years). The most common preoperative complaint was headache. The most common clinical sign was sensory dysfunction which was relieved or improved in 63% of patients. The mean syringomyelia size had a significant reduction after the surgery (p = .01). The mean tonsillar descent also had significant reduction (p = .00). The mean McRae line length before the surgery and after that were 33.4 and 53.1 mm respectively that this change was not statistically significant (p = .42). The odontoid process parameters had no significant changes after surgery. Conclusions: Posterior fossa decompression surgery with duraplasty can improve both clinical and imaging outcomes such as syringomyelia size and tonsillar descent for patients with symptomatic CM-1. However, no significant difference was found in craniometrical parameters before and after the surgery. SN - 1360-046X UR - https://www.unboundmedicine.com/medline/citation/31096790/Craniometrical_imaging_and_clinical_findings_of_adult_Chiari_malformation_type_1_before_and_after_posterior_fossa_decompression_surgery_with_duraplasty_ DB - PRIME DP - Unbound Medicine ER -