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Conservative management for pediatric patients with chiari 1 anomaly: A retrospective study
Neelan J Marianayagam1, Netanel Ben Shalom2, Omer Zarchi3
1Department of Neurosurgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Objective:
To better understand the natural history of non-surgical management of chiari 1 anomaly.
Patients And Methods:
After obtaining approval of the institutional review board, medical records and radiological exams of patients treated for CM1 at our institution between the years 2010 and 2016 were reviewed. Twenty-nine patients total were included in our study.
Results:
The average age of our patient population was 8.5 years old at the time of diagnosis. The average tonsillar herniation on first MRI was 9.4 mm (+/- 4.6) and the average tonsillar herniation on second MRI was 10.4 mm (+/- 4.8). The average follow up time of our sample of patients was 26 months. Of the 29 patients in our study 9 (31 %) had symptomatic presentation. Interestingly, four of our patients (13.8 %) presented with epilepsy.
Conclusions:
Our findings support the previous work that nonoperative management is best in asymptomatic or mildly symptomatic chiari patients.
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