Haines S J, Berger M
Department of Neurosurgery, University of Minnesota Hospital and Clinics, Minneapolis.
Neurosurgery. 1991 Mar;28(3):353-7.
The membership of the Pediatric Section of the American Association of Neurological Surgeons was surveyed with regard to attitudes in current practice in the treatment of Chiari malformations Types I and II. Ninety-six of 152 (63%) valid questionnaires were returned. The median number of malformations treated yearly by the respondents was 3 for Type I and 6 for Type II. There was substantial agreement that surgery should not be carried out on asymptomatic patients and that surgery was indicated for the treatment of brain stem dysfunction, cranial nerve dysfunction,, hydromyelia, and scoliosis associated with these malformations. There was substantial disagreement about lesser indications for surgery. The respondents also expressed dissatisfaction with the current classification of Chiari malformations. Chiari malformations are complex abnormalities, and their anatomy is being better delineated with magnetic resonance imaging. Carefully designed scientific clinical investigations are needed to improve our understanding and treatment of Chiari malformations.
美国神经外科医师协会小儿科分会就当前治疗I型和II型Chiari畸形的实践态度进行了调查。152份有效问卷中，96份（63%）被收回。受访者每年治疗的I型畸形中位数为3例，II型为6例。对于不应为无症状患者进行手术以及手术适用于治疗与这些畸形相关的脑干功能障碍、颅神经功能障碍、脊髓空洞症和脊柱侧弯，存在广泛共识。对于手术的次要指征存在很大分歧。受访者还对目前Chiari畸形的分类表示不满。Chiari畸形是复杂的异常情况，磁共振成像能更好地描绘其解剖结构。需要精心设计的科学临床研究来提高我们对Chiari畸形的理解和治疗水平。
