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Case 2.11
Published in Monica Fawzy, Plastic Surgery Vivas for the FRCS(Plast), 2023
A Chiari 1 malformation occurs when the one or both cerebellar tonsils descend through the foramen magnum. Treatment should be considered if symptomatic or associated with a syringomyelia. In children with raised ICP due to cephalocranial disproportion, teams may often consider posterior vault expansion, and if this is not successful, then progress to a foramen magnum decompression.
Disorders of Circulation of the Cerebrospinal Fluid
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
MRI is the test of choice for detection and characterization of syringomyelia. Evaluation should include the skull base and the upper and lower extent of the syrinx. The initial examination should include postcontrast imaging to exclude the presence of a spinal cord tumor, but follow-up imaging usually does not need postcontrast imaging. If CSF flow is seen with the syrinx cavity, the syrinx is thought to be at rest for further extension.
Syringomyelia and Lower Urinary Tract Dysfunction
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Pain is the most common symptom associated with syringomyelia. The pain often localized to the affected area of the spinal cord; however, the pain may also radiate from its origin due to strain and pressure on the spinal cord. Other symptoms include paresthesia and numbness. Similar to primary syringomyelias, secondary syringomyelias can easily be seen using an MRI. On average, the spinal cavity tends to extend 3.5 vertebral segments in asymptomatic patients and 10 vertebral segments in symptomatic cases.
Syringosubarachnoid shunt: insertion technique
Published in British Journal of Neurosurgery, 2023
Meriem Amarouche, Viviana Minichini, Heather Davis, Anastasios Giamouriadis, Sanjeev Bassi
Syringomyelia is an abnormal fluid filled cavity which causes distortion of the spinal cord rendering it thinner and often causing it to bulge through the dural opening. During the approach to the syrinx through the myelotomy the dorsal columns need to be preserved in order to reduce the risk of consequent neurological deficit. On the other hand, whilst inserting the subarachnoid end of a shunt, the main anatomic landmark that needs to be identified is the dentate ligament because it can prevent adequate insertion and drainage of the shunt. These ligaments are important structures located in the pia matter on each side of the spinal cord. They are believed to provide stability to the spinal cord within the spinal canal by attaching the pia to the arachnoid and dura matters.1
Long-term surgical outcome of Chiari type-I malformation-related syringomyelia: an experience of tertiary referral hospital
Published in Neurological Research, 2022
Anas Abdallah, İrfan Çınar, Betül Güler Abdallah
Syringomyelia is a condition caused by a fluid-filled cyst in the spinal cord [6,7]. It also can be caused by intramedullary lesions and idiopathic, congenital, or traumatic accidents. Syringomyelia is not a rare condition and is commonly seen in patients with CM1. The most common cause of syringomyelia is CM1 [7–9]. However, the exact relationship between CM1 and associated syringomyelia is not known. In CM1, the herniated cerebellar tonsils below the foramen magnum can reduce the cerebrospinal fluid (CSF) flow. Thus, the CSF flow in the brain and spinal canal has been affected, potentially leading to the accumulation of CSF in the subarachnoid space (SS) of the brain and spine. CM1 may increase intracranial pressure on the brain, resulting in hydrocephalus. Moreover, CM1 may increase the pressure on the medulla spinalis tissues and cause CSF to accumulate in the central channel [3,8,9].
Long-term outcomes of surgical management in subtypes of Chiari malformation
Published in Neurological Research, 2021
Recep Basaran, Caglar Bozdogan, Mehmet Senol, Dogan Gundogan, Nejat Isik
Aims of this study: We aimed to collect a large series of patients that includes some CM subtypes and to evaluate the clinical outcomes for each subgroup of patients.CM 0 is a relatively new identified subgroup of Chiari malformations. First, we collected CM-0 patients, and then analyzed their clinical outcomes.Like CM-0, CM-1.5 is a relatively new identified subgroup of Chiari malformations. We search for patients operated in our clinic that fit into this category, analyzed their results, and reported their differences from CM-1 about surgical strategy, follow-up, and clinical outcome.Is the symptom duration important for clinical outcome? Does it affect the choice of surgical procedure and clinical outcome?Is Syringomyelia existence important for symptom duration, neurological condition, surgical strategy, and clinical outcome?We aimed to compare similar operations and similar subgroups and to search for an answer to the question ‘which surgical procedure must be first choice in which subtypes? Is this kind of surgical procedure important for clinical outcome?