Suboccipital craniectomy with or without duraplasty: what is the best choice in patients with Chiari type 1 malformation?



Document title: Suboccipital craniectomy with or without duraplasty: what is the best choice in patients with Chiari type 1 malformation?
Journal: Arquivos de neuro-psiquiatria
Database: PERIÓDICA
System number: 000328315
ISSN: 0004-282X
Authors: 1
1
Institutions: 1Hospital Heliopolis, Servico de Neurocirurgia, Sao Paulo. Brasil
Year:
Season: Ago
Volumen: 68
Number: 4
Pages: 623-626
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Experimental, aplicado
English abstract The best surgical treatment for Chiari malformation is unclear, especially in patients with syringomyelia. We reviewed the records of 16 patients who underwent suboccipital craniectomy at our institution between 2005 and 2008. Of the six patients who did not undergo duraplasty, four showed improvement postoperatively. Two patients without syringomyelia showed improvement postoperatively. Of the four patients with syringomyelia, three showed improvement, including two with a decrease in the cavity size. One patient showed improvement in symptoms but the syringomyelia was unchanged. The cavity size increased in the one patient who did not show improvement. Among the 10 patients who underwent duraplasty, improvements were noted in four of the five patients without syringomyelia and in all of the five with syringomyelia. There is a suggestion that patients with syringomyelia may have a higher likelihood of improvement after undergoing duraplasty
Portuguese abstract A melhor opção de tratamento cirúrgico na malformação de Chiari é desconhecido, especialmente em paciente com siringomielia. Nós revisamos casos de 16 pacientes submetidos à craniectomia suboccipital em nossa instituição de 2005 à 2008. Dos 6 pacientes que não foram submetidos à duroplastia, quatro tiveram melhora pós operatória. Dois pacientes sem siringomielia tiveram melhora pós operatória. Dos quatro pacientes com siringomielia, três tiveram melhora, incluindo dois com diminuição do tamanho da cavidade. Um paciente teve melhora da sintomatologia mas a siringomielia não se modificou. Dez pacientes foram submetidos à duroplastia. Melhora foi observada em 4 de 5 pacientes sem siringomielia e 5 de 5 casos com siringomielia. Há uma sugestão de que pacientes com siringomielia possam ter uma maior taxa de melhora após serem submetidos à duroplastia
Disciplines: Medicina
Keyword: Cirugía,
Neurología,
Siringomielia,
Malformación de Chiari,
Abordaje quirúrgico,
Craniectomía
Keyword: Medicine,
Neurology,
Surgery,
Syringomyelia,
Chiari malformation,
Surgical approach,
Craniectomy
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