Resolution of syringomyelia in ten cases of "up-and-down Chiari malformation" after posterior fossa decompression

• Published in: Arquivos de neuro-psiquiatria Vol. 68; no. 5; pp. 694 - 699
• Main Authors: Silva, José Alberto Gonçalves da, Melo, Luiz Ricardo Santiago, Araújo, Antônio Fernandes de, Santos, Jr, Adailton Arcanjo Dos
• Format: Journal Article
• Language: English
• Published: Brazil Academia Brasileira de Neurologia - ABNEURO 01-10-2010
• Subjects: Adult; Arnold-Chiari Malformation - complications; Arnold-Chiari Malformation - surgery; Cranial Fossa, Posterior - surgery; Decompressive Craniectomy - methods; Dura Mater - surgery; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; NEUROSCIENCES; Patient Positioning; PSYCHIATRY; Retrospective Studies; Syringomyelia - etiology; Syringomyelia - surgery; Treatment Outcome; syringomyelia; craniovertebral decompression; descompressão craniovertebral; Chiari malformation; malformação de Chiari; siringomielia
• ISSN: 0004-282X; 1678-4227; 1678-4227; 0004-282X
• DOI: 10.1590/S0004-282X2010000500004

The authors describe ten cases of syringomyelia without hindbrain herniation depicted by preoperative magnetic resonance imaging (MRI) in supine position. However, the herniation was observed in all cases during the operation with the patient in sitting position. The postoperative MRI revealed an intense reduction of the syrinx in all patients, as well as it was also observed a clinical amelioration in all cases. The surgical treatment was based on a large craniectomy with the patient in sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large cisterna magna.