BOOK
Chiari Malformation, An Issue of Neurosurgery Clinics of North America, E-Book
(2016)
Additional Information
Book Details
Abstract
This issue will cover chiari malformation in both children and adult populations. In the past, it was estimated that the condition occurs in about one in every 1,000 births. However, the increased use of diagnostic imaging has shown that CM may be much more common. Complicating this estimation is the fact that some children who are born with the condition may not show symptoms until adolescence or adulthood, if at all. CMs occur more often in women than in men and Type II malformations are more prevalent in certain groups, including people of Celtic descent.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Contributors | iii | ||
| CONSULTING EDITORS | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | v | ||
| Preface: Chiari I Malformation: Adult and Pediatric Considerationsxiii | v | ||
| Definitions and Anatomic Considerations in Chiari I Malformation and Associated Syringomyelia487 | v | ||
| Pathogenesis and Cerebrospinal Fluid Hydrodynamics of the Chiari I Malformation495 | v | ||
| Prevalence of Chiari I Malformation and Syringomyelia501 | v | ||
| Clinical Presentation of Chiari I Malformation and Syringomyelia in Children509 | v | ||
| Clinical Presentation and Alternative Diagnoses in the Adult Population515 | vi | ||
| Advanced Imaging of Chiari 1 Malformations519 | vi | ||
| Surgical Treatment of Chiari I Malformation527 | vi | ||
| Clinical Outcome Measures in Chiari I Malformation533 | vi | ||
| Surgical History of Sleep Apnea in Pediatric Patients with Chiari Type 1 Malformation543 | vii | ||
| Complex Chiari Malformations in Children: Diagnosis and Management555 | vii | ||
| Craniovertebral Junction Instability in the Setting of Chiari I Malformation561 | vii | ||
| Ventral Decompression in Chiari Malformation, Basilar Invagination, and Related Disorders571 | vii | ||
| Spinal Deformity Associated with Chiari Malformation579 | vii | ||
| Erratum | xi | ||
| Chiari I Malformation: Adult and Pediatric Considerations | xiii | ||
| REFERENCES | xiv | ||
| Definitions and Anatomic Considerations in Chiari I Malformation and Associated Syringomyelia | 487 | ||
| Key points | 487 | ||
| INTRODUCTION | 487 | ||
| DEFINITION | 487 | ||
| ANATOMIC FINDINGS OF THE CHIARI I MALFORMATION | 488 | ||
| Skull | 489 | ||
| Spine | 489 | ||
| Ventricles and Cisterns | 489 | ||
| Fourth Ventricular Outlet Obstruction | 490 | ||
| Meninges | 490 | ||
| Spinal Cord and Syringomyelia | 490 | ||
| Brain | 491 | ||
| Brainstem and cerebellar tonsils | 491 | ||
| FORME FRUSTE | 491 | ||
| Chiari 1.5 | 491 | ||
| Chiari 0 | 491 | ||
| SUMMARY | 492 | ||
| REFERENCES | 492 | ||
| Pathogenesis and Cerebrospinal Fluid Hydrodynamics of the Chiari I Malformation | 495 | ||
| Key points | 495 | ||
| INTRODUCTION | 495 | ||
| PATHOGENESIS OF THE CHIARI I MALFORMATION | 496 | ||
| Limited Embryologic Development of the Skull Base | 496 | ||
| Hemodynamic Disturbance of the Central Nervous System | 497 | ||
| Herniation of the Cerebellar Tonsils Associated with Posterior Fossa Tumors | 497 | ||
| Cranio-Spinal Pressure Imbalance Associated with Low Spinal Intrathecal Pressure | 497 | ||
| Complete Reversal of the Abnormal Shape and Position of the Chiari I Malformation with Surgical Treatment of Syringomyelia | 497 | ||
| PATHOPHYSIOLOGY ASSOCIATED WITH CHIARI I MALFORMATION | 498 | ||
| SUMMARY | 498 | ||
| REFERENCES | 498 | ||
| Prevalence of Chiari I Malformation and Syringomyelia | 501 | ||
| Key points | 501 | ||
| IMAGING PREVALENCE OF CHIARI I MALFORMATION | 501 | ||
| PREVALENCE OF SYMPTOMATIC CHIARI I MALFORMATION | 504 | ||
| PREVALENCE OF SPINAL CORD SYRINX IN PATIENTS WITH CHIARI I MALFORMATION | 504 | ||
| SUMMARY | 506 | ||
| REFERENCES | 506 | ||
| Clinical Presentation of Chiari I Malformation and Syringomyelia in Children | 509 | ||
| Key points | 509 | ||
| INTRODUCTION | 509 | ||
| CLINICAL PRESENTATION DURING THE NEONATAL PERIOD AND INFANCY (AGE 0 TO 3 YEARS) | 511 | ||
| CLINICAL PRESENTATION IN TODDLERS (AGE 3 TO 5 YEARS) | 511 | ||
| CLINICAL PRESENTATION DURING CHILDHOOD AND ADOLESCENCE (AGE 5 YEARS AND OLDER) | 511 | ||
| CLINICAL CONDITIONS ASSOCIATED WITH CHIARI I MALFORMATION | 513 | ||
| RARE PRESENTATIONS OF CHIARI I MALFORMATION IN CHILDREN | 513 | ||
| SUMMARY | 514 | ||
| REFERENCES | 514 | ||
| Clinical Presentation and Alternative Diagnoses in the Adult Population | 515 | ||
| Key points | 515 | ||
| SYMPTOMS IN THE ADULT CHIARI PATIENT | 515 | ||
| ALTERNATIVE DIAGNOSES | 516 | ||
| SUMMARY | 517 | ||
| REFERENCES | 517 | ||
| Advanced Imaging of Chiari 1 Malformations | 519 | ||
| Key points | 519 | ||
| BACKGROUND | 519 | ||
| RADIOLOGIC DIAGNOSIS | 520 | ||
| ADVANCED IMAGING | 520 | ||
| Cerebrospinal Fluid Flow MRI | 520 | ||
| Cine MRI of Tonsillar Motion | 522 | ||
| Diffusion Tensor Imaging | 523 | ||
| Postsurgical Outcome | 523 | ||
| SUMMARY | 525 | ||
| SUPPLEMENTARY DATA | 525 | ||
| REFERENCES | 525 | ||
| Surgical Treatment of Chiari I Malformation | 527 | ||
| Key points | 527 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 527 | ||
| SURGICAL TECHNIQUE | 528 | ||
| Preoperative Planning | 528 | ||
| Preparation and Patient Positioning | 528 | ||
| Surgical Procedure | 528 | ||
| Step 1: soft tissue dissection | 528 | ||
| Step 2: bony decompression | 529 | ||
| Step 3: dural opening | 529 | ||
| Step 4: ensuring adequacy of fourth ventricle outlet | 529 | ||
| Step 5: closure of the dura | 530 | ||
| Postoperative Care | 530 | ||
| CLINICAL RESULTS IN THE LITERATURE | 530 | ||
| SUMMARY | 530 | ||
| SUPPLEMENTARY DATA | 530 | ||
| REFERENCES | 530 | ||
| Clinical Outcome Measures in Chiari I Malformation | 533 | ||
| Key points | 533 | ||
| INTRODUCTION | 533 | ||
| GENERAL OUTCOME MEASURES | 534 | ||
| QUALITY OF LIFE AND DISABILITY SCALES | 534 | ||
| Neck Disability Index | 535 | ||
| Short Form-12 | 535 | ||
| DISEASE-SPECIFIC OUTCOME MEASURES | 535 | ||
| Japanese Orthopaedic Association Dysfunction Score | 535 | ||
| Asgari Score | 535 | ||
| Chicago Chiari Outcome Score | 535 | ||
| Klekamp and Samii Score | 539 | ||
| Chiari Symptom Profile | 539 | ||
| DISCUSSION | 539 | ||
| SUMMARY | 539 | ||
| REFERENCES | 539 | ||
| Surgical History of Sleep Apnea in Pediatric Patients with Chiari Type 1 Malformation | 543 | ||
| Key points | 543 | ||
| INTRODUCTION | 543 | ||
| METHODS | 544 | ||
| Clinical Evaluation | 544 | ||
| Imaging | 544 | ||
| Sleep Evaluation | 544 | ||
| Surgical Technique | 545 | ||
| Duraplasty | 545 | ||
| Dural Splitting | 545 | ||
| RESULTS | 546 | ||
| Patient Characteristics | 546 | ||
| Imaging Characteristics | 546 | ||
| Clinical Characteristics | 547 | ||
| Evaluation of Cerebrospinal Fluid Flow | 549 | ||
| CLINICAL RESULTS IN THE LITERATURE | 549 | ||
| SUMMARY | 551 | ||
| SUPPLEMENTARY DATA | 551 | ||
| REFERENCES | 551 | ||
| Complex Chiari Malformations in Children | 555 | ||
| Key points | 555 | ||
| DEFINITION OF COMPLEX CHIARI MALFORMATION | 555 | ||
| PATIENT SELECTION | 556 | ||
| Clinical Findings | 556 | ||
| Radiographic Findings | 556 | ||
| Clinical-Radiographic Integration | 556 | ||
| Step 1: surgical decision making | 556 | ||
| Step 2: radiologic evaluation | 557 | ||
| OPERATIVE INTERVENTION | 558 | ||
| Patient-Treatment Algorithm | 558 | ||
| Operative Procedures | 558 | ||
| SUMMARY | 560 | ||
| REFERENCES | 560 | ||
| Craniovertebral Junction Instability in the Setting of Chiari I Malformation | 561 | ||
| Key points | 561 | ||
| INTRODUCTION | 561 | ||
| SCOPE OF THE PROBLEM | 562 | ||
| DIAGNOSIS | 563 | ||
| Clinical Findings | 563 | ||
| Radiographic Findings | 564 | ||
| Basilar invagination | 564 | ||
| Ventral brainstem compression | 564 | ||
| Craniocervical angulation | 564 | ||
| Chiari 1.5 | 565 | ||
| Genetic Syndromes | 565 | ||
| Ehlers-Danlos syndrome and other hereditary disorders of connective tissue | 565 | ||
| SURGICAL TECHNIQUE | 565 | ||
| Preoperative Planning | 565 | ||
| Imaging | 565 | ||
| Preoperative halo traction or reduction | 565 | ||
| Preparation and Positioning | 566 | ||
| Surgical Approach | 566 | ||
| Immediate Postoperative Care | 568 | ||
| DISCUSSION | 568 | ||
| REFERENCES | 568 | ||
| Ventral Decompression in Chiari Malformation, Basilar Invagination, and Related Disorders | 571 | ||
| Key points | 571 | ||
| INTRODUCTION | 571 | ||
| VENTRAL BRAINSTEM DECOMPRESSION | 571 | ||
| Background | 571 | ||
| Ventral Brainstem Compression in Chiari Malformation, Type I | 571 | ||
| Incidence of Ventral Brainstem Compression in Basilar Invagination and Related Disorders | 572 | ||
| DIAGNOSIS OF VENTRAL BRAINSTEM COMPRESSION | 572 | ||
| Clinical Examination | 572 | ||
| Radiographic Findings | 572 | ||
| TREATMENT OF VENTRAL BRAINSTEM COMPRESSION IN THE CONTEXT OF CHIARI MALFORMATION, TYPE I | 573 | ||
| Nonoperative (Conservative) | 573 | ||
| Surgical Treatment | 574 | ||
| Goals of surgery | 574 | ||
| Ventral approaches to craniocervical junction | 574 | ||
| Open transoral approach | 574 | ||
| Positioning and application of transoral retractor system | 574 | ||
| Incision and muscle dissection | 574 | ||
| Removal of C1 arch and odontoidectomy | 575 | ||
| Closure | 575 | ||
| Endoscopic transnasal or transoral approach | 575 | ||
| Positioning and approach | 575 | ||
| Closure | 576 | ||
| Transmaxillary and high cervical retropharyngeal approaches | 576 | ||
| Sequence of procedures | 576 | ||
| Case example | 576 | ||
| SUMMARY | 577 | ||
| REFERENCES | 578 | ||
| Spinal Deformity Associated with Chiari Malformation | 579 | ||
| Key points | 579 | ||
| INTRODUCTION | 579 | ||
| CLINICAL PRESENTATION | 579 | ||
| RADIOGRAPHIC EVALUATION | 580 | ||
| MANAGEMENT | 581 | ||
| Decompression of Chiari | 581 | ||
| Nonoperative Management | 582 | ||
| Surgical Management of Spinal Deformity | 583 | ||
| SUMMARY | 584 | ||
| DISCLOSURE | 584 | ||
| REFERENCES | 584 | ||
| Index | 587 | ||
| A | 587 | ||
| B | 587 | ||
| C | 587 | ||
| D | 587 | ||
| E | 588 | ||
| F | 588 | ||
| G | 588 | ||
| H | 588 | ||
| I | 588 | ||
| J | 588 | ||
| K | 588 | ||
| L | 588 | ||
| M | 588 | ||
| N | 588 | ||
| O | 588 | ||
| P | 589 | ||
| Q | 589 | ||
| R | 589 | ||
| S | 589 | ||
| T | 589 | ||
| V | 589 | ||
| W | 589 | ||
| Z | 589 |