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[Adult Chiari malformation--five operative cases]
No Shinkei Geka. Neurological Surgery
|March 1, 1985
Summary
Diagnosis of adult Chiari malformation is now easier with high-resolution CT. Surgical decompression improved cerebellar and some central cord symptoms in most patients, highlighting the need for careful surgical consideration.
Area of Science:
- Neurosurgery
- Radiology
Background:
- Adult Chiari malformation diagnosis has improved with advanced imaging.
- High-resolution CT and CT metrizamide myelography aid in identifying this condition.
Observation:
- Five adult Chiari malformation cases (2 male, 3 female; ages 15-55) were diagnosed using CT metrizamide myelography.
- Symptoms varied, including foramen magnum compression, cerebellar dysfunction, lower cranial nerve deficits, central cord symptoms, headache, and vertigo.
- All patients underwent suboccipital craniectomy and upper cervical laminectomy.
Findings:
- Remarkable improvement in cerebellar symptoms was observed post-surgery.
- Partial improvement in central cord symptoms occurred in some cases.
- Outcomes varied: three patients were in good condition, one was unchanged, one deteriorated, and one with headache/vertigo had an unsuccessful result.
Implications:
- CT metrizamide myelography facilitates the diagnosis of adult Chiari malformation.
- Careful patient selection and surgical planning are crucial for favorable outcomes.
- Despite rarity in Japan, adult Chiari malformation requires meticulous surgical management based on symptom severity.