Investigators at University of Florida publish new data on neurosurgery
2007 NOV 20 -- According to a study from the United States, "Despite progress in the understanding of the causes and pathophysiology of Chiari malformation Type I (CM-I), definitive surgical treatment remains unresolved. Various techniques have been propounded over the years, but there is no general consensus on the most appropriate surgical management for this condition." "The authors report their experience with the surgical treatment of 30 pediatric patients with CM-IThe results obtained in 30 patients who underwent surgery for symptomatic CM-I with a purely extradural procedure were retrospectively reviewed. The patient age at operation ranged from 2 months to 16 years (mean 68 months). In 26 patients the CM-I occurred as an isolated disease, whereas in four a recognized bone anomaly involving the cranial base (achondroplasia) was observed. All patients underwent suboccipital craniectomy, which was accompanied by C-I laminectomy in 22. In all cases a thick fibrous band at the level of foramen magnum was resected; in 11 children serial incisions of the outer layer of the dura mater were performed as well to expand the posterior fossa volume. The follow-up duration varied from a minimum of 12 months to 12.6 years (mean 4.7 years). The most frequent symptoms and signs were head and/or neck pain (56.7%), followed by vertigo (27.7%), upper- and lower-extremity weakness (20.0%), and ataxia (20.0%). Syringomyelia was noted in 12 patients (40.0%) on magnetic resonance (MR) images. Improvement in or resolution of clinical symptoms and signs was observed in all patients. However, only minimal or no modifications could be found in the position of cerebellar tonsils on postoperative MR images in most patients (only occasional improvement in tonsillar herniation), whereas syringomyelic cavitations reduced in size in half of the cases," wrote H.E. James and colleagues, University of Florida. The researchers concluded: "Nevertheless, in only two patients was a reoperation necessaryIn the authors' experience, suboccipital craniectomy and C-1 laminectomy (eventually integrated by dural delamination) can represent an effective treatment for symptoms associated with CM-I." James and colleagues published their study in the Journal of Neurosurgery (Chiari malformation Type I. Journal of Neurosurgery, 2007;107(2 Suppl. S):184). For more information, contact H.E. James, University of Florida, Wilfson Children's Hospital, Health Science Center, Jacksonville, FL 32209, USA. Publisher contact information for the Journal of Neurosurgery is: American Association Neurological Surgeons, University Virginia, 1224 West Main St., Ste. 450, Charlottesville, VA 22903, USA. Keywords: United States, Jacksonville, Neurosurgery, University of Florida. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via NewsRx.com.
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