Bidziński J, Michalik R
Katedry i Kliniki Neurochirurgii Akademii Medycznej w Warszawie.
Neurol Neurochir Pol. 1998 Sep-Oct;32(5):1181-8.
The purpose of the study was clinical analysis of the patients with Arnold-Chiari malformation and the definition of the groups according to the clinical presentation. The authors present the series of 210 patients treated between 1980 and 1997 in the Department of Neurosurgery. These patients were classified into 4 groups: syringomyelia, cerebellar syndrome, cerebello-spinal syndrome and hydrocephalus. Syringomyelia was the commonest clinical presentation in the series. Less often cerebellar and cerebello-spinal syndromes were observed. Non-communicating hydrocephalus was rare. The symptomatology of the Arnold-Chiari malformation appears extremely variable, but most often is related to the associated cavitation of the spinal cord. The signs and symptoms in patients presenting cerebellar syndrome may lead to misdiagnosis of insufficiency of the vertebrobasilar circulation. Diffuse involvement of the motor and sensory system with cerebello-spinal syndrome may cause the patient to be diagnosed incorrectly as having sclerosis multiplex. The MR is the method of choice in the diagnosis of Arnold-Chiari malformation.
本研究的目的是对患有阿诺德-奇亚里畸形的患者进行临床分析,并根据临床表现对患者群体进行界定。作者介绍了1980年至1997年间在神经外科接受治疗的210例患者的系列情况。这些患者被分为4组:脊髓空洞症、小脑综合征、小脑-脊髓综合征和脑积水。脊髓空洞症是该系列中最常见的临床表现。较少观察到小脑和小脑-脊髓综合征。非交通性脑积水罕见。阿诺德-奇亚里畸形的症状表现极为多样,但最常见的是与脊髓相关的空洞形成有关。出现小脑综合征的患者的体征和症状可能导致椎基底动脉循环不足的误诊。小脑-脊髓综合征对运动和感觉系统的弥漫性累及可能导致患者被错误诊断为患有多发性硬化症。磁共振成像(MR)是诊断阿诺德-奇亚里畸形的首选方法。