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J Neurosci Rural Pract. 2019 Jan-Mar;10(1):85-88. doi: 10.4103/jnrp.jnrp_160_18.

Surgical Experience in Pediatric Patients with Chiari-I Malformations Aged ≤18 Years.

Author information

1
Department of Neurosurgery, JIPMER, New Delhi, India.
2
Department of Anaesthesia and Critical Care, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India.
3
Department of Pathology, Sanjay Gandhi Hospital, New Delhi, India.
4
Department of Obstetrics and Gynaecology, Maharaja Agrasen Hospital, New Delhi, India.
5
Department of Neurosurgery, Maharaja Agrasen Hospital, New Delhi, India.

Abstract

Objective:

The objective of this study was to retrospectively study Chiari I malformation patients (<18 years) treated surgically.

Materials and Methods:

Chiari I malformation patients (<18 years) treated surgically at our institute were retrospectively studied.

Results:

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% (n = 3/9). Headache/neck/back pain improved in 69.56% of children (n = 16/23). Upper-extremity pain/weakness/numbness improved in 73.91% of children (n = 17/23). Ataxia improved in 66.66% of children (n = 4/6). Lower-limb weakness/hyperreflexia improved in 83.33% of children (n = 5/6). At follow-up, magnetic resonance imaging for patients with syrinx was available for 75% of patients (n = 30/50) and not available for 25% of patients (n = 10/40). Syrinx was diminished in size or resolved in 66.33% of patients (n = 19/30) and the remaining was same for 36.66% of patients (n = 11/30).

Conclusions:

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.

KEYWORDS:

Chiari malformation; duroplasty; pediatric

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