Reconstruction of the cistern magna for the treatment of Chiari Ⅰ malformation associated with syringomyelia
- VernacularTitle:枕大池重建术治疗ChiariⅠ型畸形合并脊髓空洞症
- Author:
Jun CHEN
;
Aimin LI
;
Haibin WU
- Publication Type:Journal Article
- Keywords:
Chiari Ⅰ malformation;
Syringomyelia;
Pseduomembane;
Cerebellar tonsils;
Cistern magna
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate surgical performance of reconstruction of the cistern magna for the treatment of Chiari Ⅰ malformation associated with syringomyelia.Methods Suboccipital craniotomy and laminectomy of C1 segment were performed.The superior edge of bone window was limited to the inferior nuchal line.The dura mater and arachnoid were opened Y-shaped.The cerebellar tonsils were removed by electrocoagulation or subpially.A communication of cerebrospinal fluid between the fourth ventricle and subarachnoid space was achieved.The pseduomembrane,which is a very thin membrane over the opening of the central canal,should be cut away,with fascia grafting.Then a new enlarged cistern magna was established.Results The procedure was successfully completed in all the 36 patients with Chiari Ⅰ malformation and syringomyelia.The pseduomembrane was found in 30 patients.Postoperative follow-up checkups for 3 months ~ 5 years showed various degrees of recovery of sensation and muscle strength.Re-examinations with MRI revealed that the spinal cord cavity disappeared in 6 patients and decreased in size in 30 patients.Conclusions The decompression of the posterior cranial fossa,the communication of cerebrospinal fluid between the fourth ventricle and subarachnoid space,and the removal of pseduomembrane are key processes for treating Chiari Ⅰ malformation associated with syringomyelia.
