Treatment of Chiari malformation: who, when and how

@article{Imperato2011TreatmentOC,
  title={Treatment of Chiari malformation: who, when and how},
  author={Alessia Imperato and Vincenzo Seneca and Valentina Cioffi and Giuseppe Colella and Michelangelo Gangemi},
  journal={Neurological Sciences},
  year={2011},
  volume={32},
  pages={335-339}
}
There is no effective alternative to surgery in the treatment of the symptomatic cases of chiari malformation. Nonetheless, in literature there is no unanimous consensus about what is the surgical “gold standard” and which are the candidates for surgery. No doubt that intracranial hypertension and ventricular dilatation have to be investigated and treated before considering decompression. It is also very important to keep in mind that a surgery does not guarantee a complete recovery from every… 
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TLDR
It was able to show the patients who did not have hydrosyringomyelia were unlikely to develop scoliosis and there was positive correlation between improvement in hydrosyringsomyelia and the improvement in signs and symptoms.
[Symptomatic Chiari type II malformation].
TLDR
The authors report 17 cases of symptomatic Chiari type II malformation occurring in two distinct age dependent population and stress that prompt diagnosis and surgical intervention should be performed in order to produce a favorable outcome.
Malformação de Chiari do tipo II sintomática
TLDR
The authors report 17 cases of symptomatic Chiari type II malformation occurring in two distinct age dependent population and stress that prompt diagnosis and surgical intervention should be performed in order to produce a favorable outcome.
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A model based on the presence or absence of atrophy, ataxia, and scoliosis at the time of the preoperative examination has been generated that allows prediction of long-term outcome at the 95% confidence level.
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TLDR
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TLDR
Very young children presenting with oropharyngeal dysfunction, pain worsened by valsalva, or scoliosis should prompt the clinician to consider Chiari I as a possible cause, and these symptoms are very likely to improve after Chiari decompression, which can be done with low morbidity.
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TLDR
Posterior fossa decompression with duraplasty is associated with a lower risk of reoperation than PFD but a greater risk for cerebrospinal fluid-related complications and there was no significant difference between the 2 operative techniques with respect to clinical improvement or decrease in syringomyelia.
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TLDR
It is concluded that early recognition of the symptoms of brain stem compromise in neonates and young infants with spinal dysraphism coupled with urgent evaluation and decompression are effective in producing prompt resolution of the brain stem dysfunction in most affected patients.
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