[Cerebellar amygdalopexy in the management of Chiari I malformation]
Gerardo Guinto-Balanzar1, Carlos Zamorano-Bórquez, Félix Domínguez-Cortinas
1Servicios de Neurocirugía, Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México. gguinto@prodigy.net.mx
Background:
The treatment of Chiari I malformation associated with syringomyelia is controversial.
Objective:
We describe a series of patients with this disease treated during a twelve-year period. We also present clinical, surgical and radiological findings.
Material And Methods:
Forty eight patients were included; a non significant female predominance was found. Clinical course was characterized by headache, cerebellar signs and symptoms, neck pain and involvement of lower cranial nerves and pyramidal tract. The degree of tonsillar descent and syringomyelia size varied and a correlation between them was not found. Surgery consisted in an occipital craniectomy, C1 laminectomy and tonsillar elevation through bipolar coagulation and duraplasty.
Results:
The best results were observed in pain and cerebellar symptoms, while a deficit of lower cranial nerves and pyramidal tract were observed. However, in most patients we were able to slow symptom progression. No adverse effects were documented.
Conclusions:
The surgicalprocedureproposed herein is an effective and safe treatment alternative for this malformation, and its results are comparable to other riskier procedures.
