Department of Neurosurgery, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Dipartimento di Neuroscienze, riabilitazione, oftalmologia, genetica e scienze materno-infantili (DINOGMI), Università di Genova, Genova, Italy.
Neurosurg Rev. 2020 Dec;43(6):1473-1492. doi: 10.1007/s10143-019-01198-x. Epub 2019 Nov 10.
Cerebellar tonsil herniation comprises a spectrum of disorders sharing a common neuroimaging finding consisting of downward displacement of the cerebellar tonsils through the foramen magnum and into the upper cervical spinal canal. This not uncommon condition may result from a large host of congenital or acquired causes, and confusion regarding its classification and pathogenesis still exists. Terminology also remains heterogeneous, including inconsistencies in the usage of the "Chiari 1" monicker. In this paper, the hypothesized mechanisms of development of tonsillar herniation are reviewed and strategies of management are discussed, with particular attention to surgical options adapted to the underlying etiology. A focus will be placed on acquired causes of tonsillar herniation.
小脑扁桃体疝包括一系列疾病，这些疾病具有一个共同的神经影像学发现，即小脑扁桃体通过枕骨大孔向下移位，并进入上颈段椎管。这种并不少见的情况可能是由大量先天性或后天性原因引起的，并且对于其分类和发病机制仍存在混淆。术语也仍然存在不一致，包括“Chiari 1”名称的用法不一致。本文回顾了扁桃体疝发展的假设机制，并讨论了治疗策略，特别关注针对潜在病因的手术选择。重点将放在扁桃体疝的后天性病因上。
