Türk Nöroşirürji Dergisi 1999 , Vol 9 , Num 3
SURGICAL TREATMENT METHODS OF CHIARI MALFORMATION TYPE I AND THE ROLE OF THE NEUROPHYSIOLOGICAL TESTS IN CHOOSING THESE METHODS
Nejat IŞIK1, Müfit KALELİOĞLU1, Nihal IŞIK2, Ajlan ÇERÇİ1, Ramazan UYAR1
1SSK Göztepe Eğitim Hastanesi Nöroşirürji Kliniği, Göztepe, İstanbul
2SSK Göztepe Eğitim Hastanesi Nöroloji Kliniği Göztepe, İstanbul
The Chiari malformation is a congenital anomaly of the hindbrain. It is characterized by downward displacement of brainstem and cerebellum to the cervical spinal canal. If there are progressive neurological deficits and associated pathologies, surgical therapy is necessary. In this study, 35 patients with Chiari malformation type I were presented. The patients were divided to three groups according to their associated pathologies. In all cases pre and postoperative brains tern auditory and somatosensorial evoked potentials have been done. Three of them haven't had surgical treatment, 32 patients have been operated by choosing the method according to their neurological findings and neurophysiological tests. Eleven patients without associated pathologies have been treated by craniovertebral decompression. In one case, anterior decompression has been done. Five patients with syringomyelia have had syringopleural shunting, 2 patients with syringomyelia have had craniovertebral decompression and 8 patients have been treated by craniovertebral decompression and syringopleural shunt. In 3 patients with hydrocephalus only ventriculoperitoneal shunting have been done. In one patient with hydrocephalus and syringomyelia, both syringopleural and ventriculoperitoneal shunting have been applied. Another patient who had brain stem compression, has been treated with ventriculoperitoneal shunting and craniovertebral decompression. Postoperatively, most of the patients showed recovery in different degrees. Our results have shown that surgical therapy is necessary in Chiari malformation type 1. Neurophysiological tests have an important role in planning the surgical treatment and follow-up in Chiari malformation type I. Anahtar Kelimeler : Chiari Malformation type I (Chiari 1), MRI (Magnetic Resonance Imaging), Neurophysiological tests[brainstem auditory (BAEP) and somatosensorial (SEP) evoked potentials], Surgery