Management opinions from different centers (Rio de Janeiro)
| Autor: | Tatiana Protzenko Cervante, Antonio Bellas, José Francisco M. Salomão |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Intraoperative Neurophysiological Monitoring Decompression Dura mater Population Clinical Decision-Making Asymptomatic 03 medical and health sciences 0302 clinical medicine medicine Humans education Child Ultrasonography Interventional Retrospective Studies education.field_of_study Neck pain business.industry Disease Management Infant General Medicine Syringomyelia Surgery Arnold-Chiari Malformation Pseudomeningocele medicine.anatomical_structure 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Female Neurology (clinical) Neurosurgery medicine.symptom Complication business 030217 neurology & neurosurgery Brazil |
| Zdroj: | Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. 35(10) |
| ISSN: | 1433-0350 |
| Popis: | The surgical treatment of Chiari type 1 (CM1) malformation is controversial and depends largely on the preference of the surgeon. The evolution of neuroimaging resulted in an increased number of asymptomatic patients incidentally diagnosed. To study retrospectively a population of 24 symptomatic patients with CM1 operated between 1999 and 2017 in which intraoperative ultrasonography (IOUS)–assisted posterior fossa-C1 decompression was used to decide whether the dura mater should be opened (CVD+) or not (CVD). Most of the patients complained of headache or neck pain, 15 had hydrosyringomyelia and 14 had some spinal cord involvement. Patients were categorized in improved, unchanged, or worse according the preoperative signs and symptoms. Overall, 19 patients improved, 3 deteriorated, and 2 remained unchanged. Among these, 4 out 5 had syringohydromyelia. IOUS-assisted posterior fossa-C1 decompression is our preferred option to treat CM1. Children submitted to intradural procedures, initially or subsequently, had increased postoperative complications. CSF fistula or pseudomeningocele was the major cause of complication. The final result seems to correlate with the preoperative neurological status. |
| Databáze: | OpenAIRE |
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