Management of Chiari malformations

opinions from different centers—a review

David S. Hersh, Mari L. Groves, Frederick Boop

Research output: Contribution to journalArticle

Abstract

Purpose: Surgical decision-making in Chiari malformation type I (CM-I) patients tends to depend on the presence of neurological signs and symptoms, syringomyelia, and/or scoliosis, but significant variability exists from center to center. Here, we review the symptoms of CM-I in children and provide an overview of the differences in opinion regarding surgical indications, preferred surgical techniques, and measures of outcome. Methods: A review of the literature was performed to identify publications relevant to the surgical management of pediatric CM-I patients. Results: Most surgeons agree that asymptomatic patients without syringomyelia should not undergo prophylactic surgery, while symptoms of brainstem compression and/or lower cranial nerve dysfunction warrant surgery. Patients between these extremes, however, remain controversial, as does selection of the most appropriate surgical technique. Conclusions: The optimal surgical procedure for children with CM-I remains a point of contention, and widespread variability exists between and within centers.

Original languageEnglish (US)
JournalChild's Nervous System
DOIs
StatePublished - Jan 1 2019

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Arnold-Chiari Malformation
Syringomyelia
Cranial Nerves
Scoliosis
Brain Stem
Signs and Symptoms
Publications
Decision Making
Outcome Assessment (Health Care)
Pediatrics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Management of Chiari malformations : opinions from different centers—a review. / Hersh, David S.; Groves, Mari L.; Boop, Frederick.

In: Child's Nervous System, 01.01.2019.

Research output: Contribution to journalArticle

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