Singhal Ghanshyam Das, Singhal Shakti, Agrawal Gunjan, Singhal Deepti, Arora Vipin
Department of Neurosurgery, JIPMER, New Delhi, India.
Department of Anaesthesia and Critical Care, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India.
J Neurosci Rural Pract. 2019 Jan-Mar;10(1):85-88. doi: 10.4103/jnrp.jnrp_160_18.
The objective of this study was to retrospectively study Chiari I malformation patients (<18 years) treated surgically.
Chiari I malformation patients (<18 years) treated surgically at our institute were retrospectively studied.
During the study period between January 1999 and June 2011, fifty patients, aged ≤18 years with Chiari malformation, were treated surgically and formed the basis for this series. There were 21 female children (42%) and 29 male children (58%), with a female-to-male ratio of 1:1. At the last follow-up, oropharyngeal symptoms were improved in 33% ( = 3/9). Headache/neck/back pain improved in 69.56% of children ( = 16/23). Upper-extremity pain/weakness/numbness improved in 73.91% of children ( = 17/23). Ataxia improved in 66.66% of children ( = 4/6). Lower-limb weakness/hyperreflexia improved in 83.33% of children ( = 5/6). At follow-up, magnetic resonance imaging for patients with syrinx was available for 75% of patients ( = 30/50) and not available for 25% of patients ( = 10/40). Syrinx was diminished in size or resolved in 66.33% of patients ( = 19/30) and the remaining was same for 36.66% of patients ( = 11/30).
The main goal of surgery is to arrest the progression of neurological deficits. Foramen magnum decompression with a lax duroplasty is the surgical procedure of choice.
本研究的目的是对接受手术治疗的Chiari I型畸形患者（年龄<18岁）进行回顾性研究。
对在我院接受手术治疗的Chiari I型畸形患者（年龄<18岁）进行回顾性研究。
在1999年1月至2011年6月的研究期间，50例年龄≤18岁的Chiari畸形患者接受了手术治疗，并构成了本系列研究的基础。其中有21名女童（42%）和29名男童（58%），男女比例为1:1。在最后一次随访时，33%（=3/9）的患者口咽症状得到改善。69.56%的儿童（=16/23）头痛/颈部/背部疼痛得到改善。73.91%的儿童（=17/23）上肢疼痛/无力/麻木得到改善。66.66%的儿童（=4/6）共济失调得到改善。83.33%的儿童（=5/6）下肢无力/反射亢进得到改善。在随访时，75%的患者（=30/50）有关于空洞的磁共振成像资料，25%的患者（=10/40）没有。66.33%的患者（=19/30）空洞大小缩小或消失，其余36.66%的患者（=11/30）情况保持不变。
手术的主要目标是阻止神经功能缺损的进展。枕骨大孔减压并进行宽松的硬脑膜成形术是首选的手术方式。
