Abstract:
BACKGROUND:The asymmetry of tonsillar ectopia, syringomyelia, and clinical manifestations, and their correlations in adult Chiari I malformation (CIM) are seldom discussed. METHODS:Clinical and imaging data of 104 consecutive adult patients with CIM and syringomyelia were retrospectively reviewed. A method was devised to quantify tonsillar and syrinx asymmetry. Correlations between the asymmetrically displaced cerebellar tonsils, the side of the syrinx, clinical presentations, and the curve direction of scoliosis were investigated. RESULTS:Tonsillar ectopia was left dominant in 46 patients (44.2 %), right dominant in 49 (47.1 %), and symmetrical in nine (8.7 %). The syrinx was left deviated in 44 patients (42.3 %), right deviated in 48 (46.2 %), and centrally located in 12 (11.5 %). A significant correlation was observed between the side of tonsillar herniation and the side of the syrinx (p < 0.001), and also between the descending ratio of tonsillar herniation and the deviation ratio of the syrinx (p < 0.001). The main side the of clinical presentations showed significant correlation with the dominant side of tonsillar herniation (p = 0.009) and the side of syrinx deviation (p = 0.012). In the 49 patients (47.1 %) with associated scoliosis, the curve direction was significantly related to not only the dominant side of tonsillar ectopia (p = 0.0,28) but also the deviated side of the syrinx (p = 0.044). Moreover, the curve magnitude was significantly correlated with the distance of the tonsillar herniation (p = 0.001). CONCLUSIONS:In adult CIM, most tonsillar herniations are asymmetrical and most syringomyelia is eccentrical. We speculate that the dominant side of tonsillar herniation determines the side of syrinx deviation, which in turn determines the main side of clinical presentations and the convex side of scoliosis. Our results suggest that the more the descended tonsil tilts to one side, the more the syrinx tilts to the same side.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Deng X,Wang K,Wu L,Yang C,Yang T,Zhao L,Xu Ydoi
10.1007/s00701-014-2000-5subject
Has Abstractpub_date
2014-04-01 00:00:00pages
715-22issue
4eissn
0001-6268issn
0942-0940journal_volume
156pub_type
杂志文章abstract:INTRODUCTION:Radiosurgery (RS) and fractionated radiotherapy (FRT) are part of the therapeutic armamentarium for the management of cavernous sinus meningiomas. We propose a systematic review of the local tumor control and clinical outcomes after monofractionated radiosurgical treatment, including gamma knife radiosurge...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,meta分析
doi:10.1007/s00701-018-3711-9
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Cranial nerves (CNs) crossing between the brainstem and skull base at the level of the tentorial hiatus may be at risk in temporomesial surgery involving subpial dissection and/or tumorous growth leading to distorted anatomy. We aimed to identify the surgical steps most likely to result in CN damage in this t...
journal_title:Acta neurochirurgica
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abstract:PURPOSE:To assess reliability of wall shear stress (WSS)calculations using computational fluid dynamics (CFD) dependent on inflow in internal carotid artery aneurysms (ICA). MATERIALS AND METHODS:Six unruptured ICA aneurysms were studied. 3D computational meshes were created from 3D digital subtraction angiographic im...
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doi:10.1007/s00701-010-0647-0
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abstract::A saccular cerebral aneurysm was incidentally found at the bifurcation of a fenestrated anterior cerebral artery of 35-week-old Sprague-Dawley rat. The animal had been fed a normal laboratory diet. The internal lamina extended for a short distance into the neck of the aneurysm and then suddenly disappeared. The medial...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405700
更新日期:1991-01-01 00:00:00
abstract::The clinical findings and operation results in two series of patients with medial prolapse of an intervertebral disc with total or partial occlusion of the spinal canal are reported. In one of the series (30 patients) symptoms of cauda equina compression, with bladder and rectal disturbances, were present, and in the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405333
更新日期:1978-01-01 00:00:00
abstract::In 17 primary transnasal operations on Nelson tumours long-term results are assessed measuring ACTH plasma levels and performing regular neuroradiological controls. In small intrasellar adenomas only one recurrent ACTH elevation near to pretreatment levels without symptoms from tumour growth was observed after 10 year...
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pub_type: 杂志文章
doi:10.1007/BF01405437
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abstract:BACKGROUND:Eloquent area surgery has become safer with the development of intraoperative neurophysiological monitoring and brain mapping techniques. However, the usefulness of intraoperative electric brain stimulation techniques applied to the management and surgical treatment of cavernous malformations in supratentori...
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02001462
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abstract::Acute cerebrovascular congestion after a closed head injury is significantly related to intracranial hypertension. As an indirect method of cerebral blood flow measurement; transcranial doppler sonography (TCD) provides a rapid and noninvasive assessment of cerebral haemodynamics, including hyperaemic conditions. TCD ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01476289
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abstract::We present a possible mechanism of intracerebral peritumoural haemorrhage in meningioma based on the clinical data of three of our cases. A meningioma manifesting intracerebral haemorrhage is uncommon and some sporadic case reports have been presented, but without any proven mechanisms. We are presenting three cases o...
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abstract::Although disorders of cerebral autoregulation are commonly seen in neurosurgical disease, there is currently no test of autoregulation in widespread use that may be performed safely at the bedside. The presence of autoregulation, however, can be seen in the brief hyperemic response in the middle cerebral artery distri...
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abstract::Primary spinal cord oligodendrogliomas are rare tumours. Only 3 holocord cases have been reported in the literature. We present a primary intramedullary "holocord" oligodendroglioma in a 13 year-old male. Scoliosis was the initial symptom. Neurological deterioration prompted MRI, which demonstrated the lesion. Total r...
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abstract:BACKGROUND:The supracerebellar infratentorial approach is a commonly used route in neurosurgery. It provides a narrow and deep corridor to the dorsal midbrain and pineal region. The authors describe a surgical technique to expand the operative corridor and the surgeon's working angles during this approach. METHODS:Thi...
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更新日期:2010-10-01 00:00:00
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更新日期:2014-08-01 00:00:00
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更新日期:2006-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2018-05-01 00:00:00