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A Patient-Derived Xenograft Model for Venous Malformation
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Chiari malformation: Has the dilemma ended?

Abhidha Harshad Shah1, Arjun Dhar2, Mohamed Said Mohamed Elsanafiry1

  • 1Department of Neurosurgery, KEM Hospital and Seth G S Medical College, Mumbai, Maharashtra, India.

Journal of Craniovertebral Junction & Spine
|February 7, 2018
PubMed
Summary

Chiari malformation concepts remain unclear, impacting treatment decisions. Evolving understanding shifts focus from disease to protective phenomenon, and from decompression to fixation strategies.

Keywords:
Chiari malformationhistoryinstabilitymanagementpathophysiology

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Area of Science:

  • Neurology
  • Neurosurgery
  • Medical History

Background:

  • Chiari malformation has been recognized for over a century.
  • Understanding of its pathogenesis, clinical features, and management remains inconclusive.
  • Diverse treatment approaches indicate ongoing clinical uncertainty.

Purpose of the Study:

  • To review the historical evolution of Chiari malformation concepts.
  • To highlight the lack of consensus in understanding and treating the condition.
  • To discuss the paradigm shift in treatment strategies.

Main Methods:

  • Literature review of historical and contemporary understanding of Chiari malformation.
  • Analysis of the evolution of diagnostic and therapeutic approaches.
  • Synthesis of current debates in the field.

Main Results:

  • Concepts of Chiari malformation pathogenesis and clinical presentation are still evolving.
  • A wide array of treatment methods are employed, reflecting a lack of definitive guidelines.
  • The conceptualization of Chiari malformation has shifted from a pathological process to a protective mechanism.

Conclusions:

  • The historical perspective reveals a long-standing lack of definitive understanding of Chiari malformation.
  • Current treatment strategies are diverse, indicating a need for further research and consensus.
  • The shift in understanding from disease to protective phenomenon necessitates re-evaluation of treatment from decompression to fixation.