Symptomatic Chiari Malformation and Associated Pathophysiology in Pediatric and Adult Patients without Myelodysplasia
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概要
- 論文の詳細を見る
The clinical characteristics of eight pediatric and five adult patients with Chiari malformation were evaluated. Six pediatric and five adult patients had associated syringomyelia. All patients initially underwent a suboccipital craniectomy with upper cervical (C-1 and/or C-2) laminectomy and duraplasty, and/or shunting procedures. The clinical characteristics of the pediatric and adult groups were compared. The mean interval between onset of symptoms and operation was shorter in the pediatric group (3 yrs 6 mos) than in the adult group (7 yrs 1 mo). Pediatric patients without syringomyelia had the shortest mean interval of 1 year 8 months. Preoperatively, the clinical features were more severe in the adult patients than in the pediatric patients. Postoperatively, seven of eight pediatric patients improved and one stabilized, while two of five adult patients improved, one stabilized, and in two the disease continued to progress despite multiple corrective procedures. Cine magnetic resonance imaging revealed correction of the abnormal cerebrospinal fluid (CSF) flow at the craniovertebral junction and decreased to-and-fro movement in the syrinx after posterior fossa decompression, which were closely correlated with the improvement of clinical features in pediatric patients. However, adult patients required further procedures because of the multifactorial nature of the disease. Evaluation of abnormal CSF pathways at the craniovertebral junction is important for investigating the pathogenesis of Chiari malformation and associated syringomyelia.
- 日本脳神経外科学会の論文
- 1994-11-15
著者
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MATSUDA Toshihiro
Department of Information Systems Engineering, Toyama Prefectural University
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Fukushima Takeo
Departments of Neurosurgery, Faculty of Medicine, Fukuoka University
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山本 正昭
熊本セントラル病院 脳神経外科
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TSUGU Hitoshi
Department of Neurosurgery, School of Medicine, Fukuoka University
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Tsugu Hitoshi
Department Of Neurosurgery Fukuoka University Faculty Of Medicine
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Fukushima Takeo
Department Of Neurosurgery Fukuoka University Faculty Of Medicine
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MITSUDOME Akihisa
Department of Pediatrics, School of Medicine, Fukuoka University
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TSUCHIMOCHI Hirohito
Department of Neurosurgery, Fukuoka University, Faculty of Medicine
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MATSUDA Toshihiro
Matsuda Neurosurgical Clinic
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YAMAMOTO Masaaki
Department of Neurosurgery, Fukuoka University School of Medicine
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UTSUNOMIYA Hidetsuna
Department of Radiology, Fukuoka University School of Medicine
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TOMONAGA Masamichi
Department of Neurosurgery, Fukuoka University School of Medicine
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ASAKAWA Koji
Department of Orthopedics, School of Medicine, Fukuoka University
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Mitsudome Akihisa
Department Of Pediatrics School Of Medicine Fukuoka University
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Utsunomiya Hidetsuna
Department Of Radiology Fukuoka University Faculty Of Medicine
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Utsunomiya Hidetsuna
Department Of Diagnostic Radiology Fukuoka University School Of Medicine
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Tsuchimochi Hirohito
Department Of Neurosurgery Fukuoka University Faculty Of Medicine
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Tomonaga Masamichi
Department Of Neurosurgery Faculty Of Medicine Fukuoka University
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Tomonaga Masamichi
Department Of Neurosurgery Fukuoka University School Of Medicine
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Asakawa Koji
Department Of Orthopedics School Of Medicine Fukuoka University
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山本 正昭
福岡大学 医学部脳神経外科
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Yamamoto Masaaki
Department Of Neurosurgery Fukuoka University School Of Medicine
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Fukushima Takeo
Department Of Neurosurgery Fukuoka University
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Tsuchimochi Hirohito
Department Of Neurosurgery School Of Medicine Fukuoka University
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Matsuda Toshihiro
Department Of Information Systems Engineering Toyama Prefectural University
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Tsugu Hitoshi
Departments Of Neurosurgery And Radiology Fukuoka University School Of Medicine
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Yamamoto Masaaki
Department Of Medicine Institute Of Clinical Endocrinology Tokyo Women's Medical University
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Tsugu Hitoshi
Department Of Neurosurgery Faculty Of Medicine Fukuoka University
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Fukushima Takeo
Department Of Neurosurgery Faculty Of Medicine Fukuoka University
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Yamamoto Masaaki
Department Of Dermatology Hyogo College Of Medicine
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Tsuchimochi Hirohito
Department Of Neurosurgery Fukuoka Red Cross Hospital
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Matsuda Toshihiro
Department of Electronics and Informatics, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
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Tsugu Hitoshi
Department of Neurosurgery, Faculty of Medicine, Fukuoka University
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Matsuda Toshihiro
Department of Electronics and Informatics, Toyama Prefectural University
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Yamamoto Masaaki
Department of Chemistry, Faculty of Science, Kanazawa University
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