A novel technique to treat acquired Chiari I malformation after supratentorial shunting.

Autor: Potgieser AR; Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands. a.r.e.potgieser@umcg.nl., Hoving EW; Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2016 Sep; Vol. 32 (9), pp. 1721-5. Date of Electronic Publication: 2016 Jun 11.
DOI: 10.1007/s00381-016-3138-7
Abstrakt: Purpose: The acquired Chiari I malformation with abnormal cranial vault thickening is a rare late complication of supratentorial shunting. It poses a difficult clinical problem, and there is debate about the optimal surgical strategy. Some authors advocate supratentorial skull enlarging procedures while others prefer a normal Chiari decompression consisting of a suboccipital craniectomy, with or without C1 laminectomy and dural patch grafting.
Methods: We illustrate three cases of symptomatic acquired Chiari I malformation due to inward cranial vault thickening.
Results: We describe a new surgical approach that appears to be effective in these patients. This approach includes the standard Chiari decompression combined with posterior fossa augmentation by thinning the occipital planum.
Conclusion: Internal volume re-expansion of the posterior fossa by thinning the occipital planum appears to be an effective novel surgical strategy in conjunction with the standard surgical therapy of Chiari decompression.
Competing Interests: Compliance with ethical standards Disclosures No financial disclosures. Conflict of interest The authors report no conflict of interest concerning the findings specified in this paper.
Databáze: MEDLINE
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