Time to Resolution of Symptoms After Suboccipital Decompression with Duraplasty in Children with Chiari Malformation Type I
| Autor: | Crystalann Rodriguez, Gabriel Redel-Traub, Eveline Teresa Hidalgo, Jeffrey H. Wisoff, Cordelia Orillac, Ramona Bledea, Yosef Dastagirzada, Emily North, Michelle W McQuinn, Svetlana Kvint |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Time Factors Adolescent 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine CHIARI MALFORMATION TYPE I Postoperative Complications Chart review medicine Humans Syrinx (medicine) Child Retrospective Studies business.industry Aseptic meningitis medicine.disease Decompression Surgical Single surgeon Surgery Arnold-Chiari Malformation Treatment Outcome Child Preschool Female Neurology (clinical) Dura Mater Suboccipital decompression Headaches medicine.symptom business 030217 neurology & neurosurgery Syringomyelia Follow-Up Studies |
| Zdroj: | World neurosurgery. 117 |
| ISSN: | 1878-8769 |
| Popis: | Background Duraplasty is a technique successfully used to treat Chiari malformation type I (CM-I). This study describes the timely manner of clinical outcomes and the postoperative course after craniectomy and duraplasty for the treatment of symptomatic CM-I in children. Methods A retrospective chart review was performed in 105 consecutive children who underwent surgical decompression of symptomatic CM-I with dural opening by a single surgeon between 1999 and 2015. Results In 16 of 28 children (57%) with typical Valsalva-related/tussive and mixed headaches, the symptoms resolved before discharge; by 6 months, all children were headache-free. Two of 28 children (7%) had recurrent headaches 9 months after surgery. Among the 78 children with syrinx, syrinx resolved or decreased in 68 (87%), recurred in 8 (10%), and was stable in 2 children (3%). Syrinx was resolved or decreased by 3 months in 51 children (65%) and by 6 months in 62 children (79%). Complications included aseptic meningitis requiring reoperation in 3 children (3%) and infection in one child (1%). Twelve children underwent reoperation, none within the first 30 days. No child had a major morbidity or mortality. Conclusions In carefully selected children with CM-I, a high success rate can be achieved with suboccipital decompression and duraplasty. Valsalva-related/tussive headaches resolved by the time of discharge from the hospital in the majority of children, and syrinx resolved or decreased in two-thirds of the children by 3 months. By 6 months, headaches were resolved in all cases, and syrinx was resolved or decreased in 79% of cases. |
| Databáze: | OpenAIRE |
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