Surgical treatment of type I Chiari malformation: the role of Magendie’s foramen opening e tonsils manipulation

The treatment for type 1 Chiari malformation (CM 1) is one of the most controversial topics in the neurosurgical field. The present study evaluated two of the most applied surgical techniques to treat CM 1. Method 32 patients were evaluated and divided in two groups: group 1 had 16 patients that wer...

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Main Author: Claudio Henrique Fernandes Vidal
Format: Article
Language:English
Published: Thieme Revinter Publicações 2015-02-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2015000200179&lng=en&tlng=en
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author Claudio Henrique Fernandes Vidal
author_facet Claudio Henrique Fernandes Vidal
author_sort Claudio Henrique Fernandes Vidal
collection DOAJ
description The treatment for type 1 Chiari malformation (CM 1) is one of the most controversial topics in the neurosurgical field. The present study evaluated two of the most applied surgical techniques to treat CM 1. Method 32 patients were evaluated and divided in two groups: group 1 had 16 patients that were submitted to decompression of occipital bone and dura mater of the craniovertebral junction (CVJ); group 2 also had 16 patients and in addition to the previous procedure, they were submitted to Magendie’s foramen opening e tonsils manipulation. The comparison between the groups included neurological exam and cerebrospinal fluid flow imaging during pre and postoperative periods. Results Both techniques were equivalents in terms of neurological improvement of the patients (p > 0.05), but the group 2 had more surgical complications, with relative risk of 2.45 (CI 1.55-3.86) for adverse events. Whatever the cerebrospinal fluid flow at CVJ, the patients of the group 1 achieved greater amount of flow than the group 2 (p < 0.05) during the postoperative period. Conclusion The cranial and dural decompression of the CVJ without arachnoidal violation was the best surgical intervention for treatment of CM 1, between these two compared techniques.
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spelling doaj-art-128be2f82d7c41d0b24c54c4cab1fb342025-08-20T03:54:20ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272015-02-0173217917910.1590/0004-282X20140220S0004-282X2015000200179Surgical treatment of type I Chiari malformation: the role of Magendie’s foramen opening e tonsils manipulationClaudio Henrique Fernandes VidalThe treatment for type 1 Chiari malformation (CM 1) is one of the most controversial topics in the neurosurgical field. The present study evaluated two of the most applied surgical techniques to treat CM 1. Method 32 patients were evaluated and divided in two groups: group 1 had 16 patients that were submitted to decompression of occipital bone and dura mater of the craniovertebral junction (CVJ); group 2 also had 16 patients and in addition to the previous procedure, they were submitted to Magendie’s foramen opening e tonsils manipulation. The comparison between the groups included neurological exam and cerebrospinal fluid flow imaging during pre and postoperative periods. Results Both techniques were equivalents in terms of neurological improvement of the patients (p > 0.05), but the group 2 had more surgical complications, with relative risk of 2.45 (CI 1.55-3.86) for adverse events. Whatever the cerebrospinal fluid flow at CVJ, the patients of the group 1 achieved greater amount of flow than the group 2 (p < 0.05) during the postoperative period. Conclusion The cranial and dural decompression of the CVJ without arachnoidal violation was the best surgical intervention for treatment of CM 1, between these two compared techniques.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2015000200179&lng=en&tlng=enArnold-Chiari malformationsyringomyeliacranial fossaposterior
spellingShingle Claudio Henrique Fernandes Vidal
Surgical treatment of type I Chiari malformation: the role of Magendie’s foramen opening e tonsils manipulation
Arquivos de Neuro-Psiquiatria
Arnold-Chiari malformation
syringomyelia
cranial fossa
posterior
title Surgical treatment of type I Chiari malformation: the role of Magendie’s foramen opening e tonsils manipulation
title_full Surgical treatment of type I Chiari malformation: the role of Magendie’s foramen opening e tonsils manipulation
title_fullStr Surgical treatment of type I Chiari malformation: the role of Magendie’s foramen opening e tonsils manipulation
title_full_unstemmed Surgical treatment of type I Chiari malformation: the role of Magendie’s foramen opening e tonsils manipulation
title_short Surgical treatment of type I Chiari malformation: the role of Magendie’s foramen opening e tonsils manipulation
title_sort surgical treatment of type i chiari malformation the role of magendie s foramen opening e tonsils manipulation
topic Arnold-Chiari malformation
syringomyelia
cranial fossa
posterior
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2015000200179&lng=en&tlng=en
work_keys_str_mv AT claudiohenriquefernandesvidal surgicaltreatmentoftypeichiarimalformationtheroleofmagendiesforamenopeningetonsilsmanipulation