Bansal Sumit, Borkar Sachin A, Mahapatra Ashok K
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Asian J Neurosurg. 2017 Apr-Jun;12(2):241-243. doi: 10.4103/1793-5482.144169.
Authors are presenting a common case of Chiari malformation but with a very unusual associated finding, holocord syringomyelia, which responded to posterior fossa decompression. An 11-year-old male patient presented with progressive left hemiparesis and numbness on left half of the body for 4 years. Magnetic resonance imaging of the spine revealed peg-shaped herniation of tonsils 8 mm below the foramen magnum and holocord syringomyelia. No focal intraspinal mass was seen. Chiari I malformation with holocord syrinx was diagnosed. The patient underwent posterior fossa decompression with subpial resection of both tonsils with augmentation duraplasty. Post-operatively, patient improved clinically as well as radiologically.
作者报告了一例常见的Chiari畸形病例，但伴有一个非常不寻常的相关发现——全脊髓空洞症，该病例经后颅窝减压治疗有效。一名11岁男性患者出现进行性左侧偏瘫和身体左侧麻木4年。脊柱磁共振成像显示扁桃体呈钉状疝入枕大孔下方8毫米处，并伴有全脊髓空洞症。未发现局灶性椎管内肿块。诊断为Chiari I畸形合并全脊髓空洞症。患者接受了后颅窝减压术，同时行双侧扁桃体软膜下切除术及硬脑膜修补术。术后，患者的临床症状和影像学表现均有所改善。
