Presentation and management of pediatric Chiari malformations without myelodysplasia.

Abstract:

:Chiari malformations without myelodysplasia are rarely diagnosed in the pediatric age group. With current neurodiagnostic techniques, however, they are being seen more frequently. Unfortunately, the prognosis is not clear because publications have included a number of different entities, used a variety of surgical approaches, and lacked long term follow-up. Sixteen patients younger than 20 years were treated for Chiari malformations (without myelodysplasia) between 1975 and 1985. The average age was 11 years, and the average duration of symptoms was 20 months. The common symptoms were isolated motor weakness (56%), pain (37.5%), and sensory loss (25%). Frequently seen signs were motor deficit (81%), sensory loss (50%), scoliosis (50%), and cranial nerve palsy (50%). The surgical procedures used were foramen magnum decompression (3 transoral clivus odontoid resections and 15 posterior fossa decompressions with dural grafting), alteration of cerebrospinal fluid (CSF) pathways at the cervicomedullary junction (plugging the foramen cecum and a 4th ventricle to subarachnoid shunt with posterior fossa decompression), and ventriculoperitoneal shunting (2 cases). In follow-up, 37.5% of the patients are asymptomatic, 50% are improved, and 12.5% are stable after an average follow-up period of 43 months. The asymptomatic group was younger (9.3 years) and had a shorter symptom duration (7.2 months) than both the improved (11.9 years, 16.4 months) and the stable groups (15 years, 20 months). Optimal outcome depends on complete evaluation of the abnormal CSF pathways and bony abnormalities at the craniovertebral junction. Operation is then directed toward correction of these abnormalities as delineated radiographically. Of our patients, 87.5% have at least shown improvement, which has been long term in all cases.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Dyste GN,Menezes AH

doi

10.1227/00006123-198811000-00008

subject

Has Abstract

pub_date

1988-11-01 00:00:00

pages

589-97

issue

5

eissn

0148-396X

issn

1524-4040

journal_volume

23

pub_type

杂志文章
  • Permeability of blood vessels in experimental gliomas: uptake of 99mTc-glucoheptonate and alteration in blood-brain barrier as determined by cytochemistry and electron microscopy.

    abstract::Experimental gliomas were induced in rats by prenatal exposure to ethyl nitrosourea. Changes in the blood-brain barrier were determined by the uptake of a water-soluble compound, 99mTc-glucoheptonate. Increased uptake of 99mTc-glucoheptonate was measured in intact tumors and in various sectors of dissected tumors. The...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Nir I,Levanon D,Iosilevsky G

    更新日期:1989-10-01 00:00:00

  • Nonadhesive liquid embolic agent for cerebral arteriovenous malformations: preliminary histopathological studies in swine rete mirabile.

    abstract:OBJECTIVE:To assess acute and chronic histopathological changes observed in a swine arteriovenous malformation model after endovascular delivery of Embolyx E (Micro Therapeutics Inc., San Clemente, CA) and its organic solvent dimethyl sulfoxide (DMSO). To develop standard endovascular delivery techniques of Embolyx thr...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199811000-00081

    authors: Murayama Y,Viñuela F,Ulhoa A,Akiba Y,Duckwiler GR,Gobin YP,Vinters HV,Greff RJ

    更新日期:1998-11-01 00:00:00

  • Transoral repair of a rare basioccipital meningocele in a neonate: case report.

    abstract::An extremely rare case of a basioccipital meningocele causing obstruction of the upper airway in a neonate is described. A transoral approach was used to remove the meningocele and repair the dural fistula. Bilateral posterior lateral pharyngeal releasing incisions were made to allow mucosal and muscle coverage over t...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-198909000-00027

    authors: Azizkhan RG,Cuenca RE,Powers SK

    更新日期:1989-09-01 00:00:00

  • The results, indications, and physiology of posteroventral pallidotomy for patients with Parkinson's disease.

    abstract::In the past, stereotactic surgical intervention for Parkinson's disease was considered indicated only in those patients with active motor manifestations that were refractory to pharmacological therapy, manifestations such as tremor, rigidity, dystonia, and dyskinesia. With the reintroduction and refinement of Leksell'...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199506000-00008

    authors: Iacono RP,Shima F,Lonser RR,Kuniyoshi S,Maeda G,Yamada S

    更新日期:1995-06-01 00:00:00

  • Axis fractures.

    abstract:BACKGROUND:Traumatic fractures of the second cervical vertebra are common, representing nearly 20% of all acute cervical spinal fracture-dislocation injuries. They are divided into 3 distinct injury patterns: odontoid fractures, hangman's fracture injuries, and fractures of the axis body, involving all other fracture i...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/01.NEU.0000366118.21964.A8

    authors: Pryputniewicz DM,Hadley MN

    更新日期:2010-03-01 00:00:00

  • Angles between A1 and A2 segments of the anterior cerebral artery visualized by three-dimensional computed tomographic angiography and association of anterior communicating artery aneurysms.

    abstract:OBJECTIVE:The angle of arteries at bifurcations, as well as the blood flow, are factors of hemodynamic stress on the apical region, where aneurysms often develop. Using images obtained with three-dimensional computed tomographic angiography, we sought to determine the angles between the A1 and A2 segments of the anteri...

    journal_title:Neurosurgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00006123-199907000-00021

    authors: Kasuya H,Shimizu T,Nakaya K,Sasahara A,Hori T,Takakura K

    更新日期:1999-07-01 00:00:00

  • Ipsilateral Motor Innervation Discovered Incidentally on Intraoperative Monitoring: A Case Report.

    abstract:Background and importance:Lesions in the corticospinal tract above the decussation at the medullary pyramids almost universally produce contralateral deficits. Rare cases of supratentorial lesions causing ipsilateral motor deficits have been reported previously, but only ever found secondary to stroke or congenital pyr...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyw074

    authors: Ku J,Mendelsohn D,Chew J,Shewchuk J,Dong C,Akagami R

    更新日期:2017-03-01 00:00:00

  • Determination of the minimum improvement in pain, disability, and health state associated with cost-effectiveness: introduction of the concept of minimum cost-effective difference.

    abstract:BACKGROUND:Minimum clinical important difference (MCID) has been adopted as the smallest improvement in patient-reported outcome needed to achieve a level of improvement thought to be meaningful to patients. OBJECTIVE:To use a common MCID calculation method with a cost-utility threshold anchor to introduce the concept...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000462079.96571.dc

    authors: Parker SL,McGirt MJ

    更新日期:2015-03-01 00:00:00

  • Evaluating the effect of superficial temporal artery to middle cerebral artery bypass on pure motor function using motor activation single photon emission computed tomography.

    abstract:OBJECTIVE:We evaluated and analyzed the effect of superficial temporal artery to middle cerebral artery bypass for internal carotid artery occlusion on pure motor function using motor activation single photon emission computed tomography. METHODS:Motor activation single photon emission computed tomographic (SPECT) ima...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199711000-00009

    authors: Kawaguchi S,Noguchi H,Sakaki T,Morimoto T,Hoshida T,Yonezawa T,Imai T,Ohishi H

    更新日期:1997-11-01 00:00:00

  • Tumor necrosis factor alpha expression and protein levels after fluid percussion injury in rats: the effect of injury severity and brain temperature.

    abstract:OBJECTIVE:Tumor necrosis factor alpha (TNFalpha) is elevated in some models of traumatic brain injury (TBI). However, it is unclear how TNFalpha messenger ribonucleic acid (mRNA) expression and protein levels are affected by injury severity and posttraumatic temperature modification. This study determined the regional ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000130036.52521.2c

    authors: Vitarbo EA,Chatzipanteli K,Kinoshita K,Truettner JS,Alonso OF,Dietrich WD

    更新日期:2004-08-01 00:00:00

  • Iatrogenic vertebrobasilar insufficiency after surgery of the subclavian or brachial artery: review of three cases.

    abstract:OBJECTIVE AND IMPORTANCE:Vertebrobasilar insufficiency resulting from disease of the subclavian artery is well recognized. Usually, this occurs as the "subclavian steal" syndrome in the context of chronic subclavian stenosis and is consequently well tolerated because of collateralization. Acute disruption of the hemody...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Amar AP,Levy ML,Giannotta SL

    更新日期:1998-12-01 00:00:00

  • Pathological status of the mesial temporal lobe predicts memory outcome from left anterior temporal lobectomy.

    abstract::This investigation tested the hypothesis that the degree of impairment to memory function caused by an anterior temporal lobectomy (ATL) is inversely related to the pathological status of the resected hippocampus. Specifically, the greatest risk to postoperative memory function should be to patients with no or minimal...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199210000-00006

    authors: Hermann BP,Wyler AR,Somes G,Berry AD 3rd,Dohan FC Jr

    更新日期:1992-10-01 00:00:00

  • Subarachnoid hemorrhage and intracerebral hematoma: incidence, prognostic factors, and outcome.

    abstract:OBJECTIVE:To analyze the incidence and impact of an intracerebral hematoma (ICH) on treatment and outcome in patients with aneurysmal subarachnoid hemorrhage. METHODS:Data of 585 consecutive patients with subarachnoid hemorrhage from June 1999 to December 2005 were prospectively entered in a database. ICH was diagnose...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000335170.76722.B9

    authors: Güresir E,Beck J,Vatter H,Setzer M,Gerlach R,Seifert V,Raabe A

    更新日期:2008-12-01 00:00:00

  • Capillary hemangioma in the superior sagittal sinus as a rare cause of intracranial hypertension in a child: case report.

    abstract:OBJECTIVE AND IMPORTANCE:The etiological factors involved in idiopathic intracranial hypertension are not easy to identify. This case of idiopathic intracranial hypertension was associated with a capillary hemangioma growing in the lumen of the superior sagittal sinus. CLINICAL PRESENTATION:A 10-year-old girl had expe...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neurosurgery/57.4.e815

    authors: Brotchi J,Baleriaux D,Kalangu KK,Morelli D,Rodesch G,Rorive S,Pirotte B

    更新日期:2005-10-01 00:00:00

  • Juxtafacet cysts of the cervical spine.

    abstract:OBJECTIVE:We report a retrospective series of 13 patients who presented with symptoms and signs caused by cervical juxtafacet cysts. Clinical findings, radiographic features, surgical management strategies, and possible causes are reported and discussed. METHODS:We reviewed clinical histories, radiographic studies, su...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199812000-00058

    authors: Krauss WE,Atkinson JL,Miller GM

    更新日期:1998-12-01 00:00:00

  • Middle cerebral artery aneurysm due to Nocardia asteroides: case report of aneurysm excision and extracranial-intracranial bypass.

    abstract::Nocardia asteroides is an uncommon human pathogen typically encountered in immunocompromised patients. Primary central nervous system (CNS) nocardiosis is rare and usually manifests as cerebritis or abscesses. The case of a young woman who presented with CNS Nocardia abscesses complicated by an infective middle cerebr...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Hadley MN,Spetzler RF,Martin NA,Johnson PC

    更新日期:1988-05-01 00:00:00

  • Leptomeningeal cyst resulting from adulthood trauma: case report.

    abstract::The authors report a rare sequelae of a skull fracture in an adult, a leptomeningeal cyst. A unique method for repairing this defect is described as well. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199001000-00025

    authors: Halliday AL,Chapman PH,Heros RC

    更新日期:1990-01-01 00:00:00

  • Optic canal involvement in tuberculum sellae meningiomas: influence on approach, recurrence, and visual recovery.

    abstract:BACKGROUND:Tuberculum sellae meningiomas frequently extend into the optic canals. OBJECTIVE:To emphasize the high frequency of optic canal (OC) involvement in tuberculum sellae meningiomas; the importance of opening the OC and of removing tumor within the canal; and the effect of this maneuver on visual outcome, recur...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000383153.75695.24

    authors: Mahmoud M,Nader R,Al-Mefty O

    更新日期:2010-09-01 00:00:00

  • Anxiety and depression after spontaneous subarachnoid hemorrhage.

    abstract:OBJECTIVE:Relatively little attention has been paid to emotional outcome after subarachnoid hemorrhage (SAH). This study assessed levels of anxiety and depression among SAH survivors and related these to clinical indices. METHODS:Seventy SAH patients from a consecutive series of neurosurgical admissions participated i...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000097198.94828.e1

    authors: Morris PG,Wilson JT,Dunn L

    更新日期:2004-01-01 00:00:00

  • Isolation and perivascular localization of mesenchymal stem cells from mouse brain.

    abstract:BACKGROUND:Although originally isolated from the bone marrow, mesenchymal stem cells (MSCs) have recently been detected in other tissues. However, little is known about MSCs in the brain. OBJECTIVE:To determine the extent to which cells with the features of MSCs exist in normal brain tissue and to determine the locati...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000377859.06219.78

    authors: Kang SG,Shinojima N,Hossain A,Gumin J,Yong RL,Colman H,Marini F,Andreeff M,Lang FF

    更新日期:2010-09-01 00:00:00

  • Stereotactic radiosurgery in cases of acoustic neurinoma: further experiences.

    abstract::Fourteen patients with acoustic neurinomas varying in size from 7 to 30 mm were treated by stereotactic radiosurgery and then were followed for 4 years. The tumors of eight patients decreased 1 to 10 mm in diameter, no change was found in two, and the tumor increased slightly in three patients. Loss of the ability to ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198307000-00003

    authors: Norén G,Arndt J,Hindmarsh T

    更新日期:1983-07-01 00:00:00

  • Familial colloid cyst of the third ventricle: case report and review of associated conditions.

    abstract::The cases of a father and his son who were diagnosed with pathologically confirmed colloid cysts of the third ventricle are presented. The familial occurrence of this tumor is rare and suggests that genetic factors may play a role in its formation. Consistent with the concept that the cyst originates as a developmenta...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199602000-00033

    authors: Akins PT,Roberts R,Coxe WS,Kaufman BA

    更新日期:1996-02-01 00:00:00

  • Plasma platelet-activating factor-acetyl hydrolase activity and the levels of free forms of biomarker of lipid peroxidation in cerebrospinal fluid of patients with aneurysmal subarachnoid hemorrhage.

    abstract:BACKGROUND:Free radicals and lipid peroxidation are thought to be related to the vasospasm generation after subarachnoid hemorrhage (SAH). Plasma platelet-activating factor-acetyl hydrolase (PAF-AH) degrades phospholipids with an oxidatively modified fatty acyl chain. OBJECTIVE:To compare plasma PAF-AH activity and fr...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e3182333c69

    authors: Hirashima Y,Doshi M,Hayashi N,Endo S,Akazawa Y,Shichiri M,Yoshida Y

    更新日期:2012-03-01 00:00:00

  • Brief Electrical Stimulation Promotes Nerve Regeneration Following Experimental In-Continuity Nerve Injury.

    abstract:BACKGROUND:Brief electrical stimulation (ES) therapy to the nerve may improve outcome in lacerated, repaired nerves. However, most human nerve injuries leave the nerve in continuity with variable and often poor functional recovery from incomplete axon regeneration and reinnervation. OBJECTIVE:To evaluate the effect of...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyy221

    authors: Shapira Y,Sammons V,Forden J,Guo GF,Kipp A,Girgulis J,Mishra T,de Villers Alant JD,Midha R

    更新日期:2019-07-01 00:00:00

  • Is aqueductal stroke volume, measured with cine phase-contrast magnetic resonance imaging scans useful in predicting outcome of shunt surgery in suspected normal pressure hydrocephalus?

    abstract:OBJECTIVE:To evaluate clinical usefulness of cerebrospinal fluid stroke volume (SV) assessed in the cerebral aqueduct, via cine phase-contrast magnetic resonance imaging, for predicting outcome after shunt surgery in suspected normal pressure hydrocephalus. METHODS:Thirty-eight patients with suspected normal pressure ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000249208.04344.A3

    authors: Kahlon B,Annertz M,Ståhlberg F,Rehncrona S

    更新日期:2007-01-01 00:00:00

  • Patients with moderate head injury: a prospective multicenter study of 315 patients.

    abstract:OBJECTIVE:To analyze the risk factors of worst outcome associated with moderate head injury. METHODS:Data on patients with moderate head injury were collected prospectively in 11 Italian neurosurgical units over a period of 18 months. Patients older than 18 years with blunt head injury and at least one Glasgow Coma Sc...

    journal_title:Neurosurgery

    pub_type: 杂志文章,多中心研究

    doi:10.1227/01.NEU.0000340796.18738.F7

    authors: Compagnone C,d'Avella D,Servadei F,Angileri FF,Brambilla G,Conti C,Cristofori L,Delfini R,Denaro L,Ducati A,Gaini SM,Stefini R,Tomei G,Tagliaferri F,Trincia G,Tomasello F

    更新日期:2009-04-01 00:00:00

  • Selective occlusion of basilar artery aneurysms using controlled detachable coils: report of 35 cases.

    abstract::The development of new devices, especially controlled detachable coils, has made the endovascular approach one of the modalities for the treatment of intracranial aneurysms. We describe the treatment and present the results of 35 patients treated by selective occlusion of basilar artery aneurysms in our department dur...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199605000-00019

    authors: Pierot L,Boulin A,Castaings L,Rey A,Moret J

    更新日期:1996-05-01 00:00:00

  • Theodor Kocher's craniometer.

    abstract::The first half of the 20th century witnessed the rapid emergence of neurological surgery as a surgical subspecialty. Only few surgeons made a name for themselves equally in general surgery and neurological surgery. One of them was the Swiss surgeon Theodor Kocher (1841-1917). He was honored with the Nobel Prize for hi...

    journal_title:Neurosurgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1227/01.NEU.0000344003.72056.7F

    authors: Schültke E

    更新日期:2009-05-01 00:00:00

  • Impairment of cerebral autoregulation during the development of chronic cerebral vasospasm after subarachnoid hemorrhage in primates.

    abstract::We studied the impairment of autoregulation of cerebral blood flow (CBF) and its effect on the electrical activity of the brain during the development of chronic cerebral vasospasm after subarachnoid hemorrhage, using a vasospasm model in primates. Fourteen animals were divided into two groups: a clot group (8) and a ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199101000-00007

    authors: Takeuchi H,Handa Y,Kobayashi H,Kawano H,Hayashi M

    更新日期:1991-01-01 00:00:00

  • Cerebellar hemorrhage complicating cervical laminectomy.

    abstract::A case of cerebellar hemorrhage complicating the postoperative course of a patient who had undergone a cervical laminectomy in the sitting position is presented. The drop in cerebrospinal fluid pressure accompanying the procedure is thought to have had some role in the development of the hemorrhage. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198108000-00016

    authors: Chadduck WM

    更新日期:1981-08-01 00:00:00