Journal of Neurosciences in Rural Practice
 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 10  |  Issue : 1  |  Page : 85-88

Surgical experience in pediatric patients with Chiari-I malformations aged ≤18 years


1 Department of Neurosurgery, JIPMER, New Delhi, India
2 Department of Anaesthesia and Critical Care, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India
3 Department of Pathology, Sanjay Gandhi Hospital, New Delhi, India
4 Department of Obstetrics and Gynaecology, Maharaja Agrasen Hospital, New Delhi, India
5 Department of Neurosurgery, Maharaja Agrasen Hospital, New Delhi, India

Correspondence Address:
Shakti Singhal
Department of Anaesthesia and Critical Care, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi - 110 085
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jnrp.jnrp_160_18

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Objective: The objective of this study was to retrospectively study Chiari I malformation patients (<18 years) treated surgically. Materials and Methods: Chiari I malformation patients (<18 years) treated surgically at our institute were retrospectively studied. Results: During the study period between January 1999 and June 2011, fifty patients, aged ≤18 years with Chiari malformation, were treated surgically and formed the basis for this series. There were 21 female children (42%) and 29 male children (58%), with a female-to-male ratio of 1:1. At the last follow-up, oropharyngeal symptoms were improved in 33% (n = 3/9). Headache/neck/back pain improved in 69.56% of children (n = 16/23). Upper-extremity pain/weakness/numbness improved in 73.91% of children (n = 17/23). Ataxia improved in 66.66% of children (n = 4/6). Lower-limb weakness/hyperreflexia improved in 83.33% of children (n = 5/6). At follow-up, magnetic resonance imaging for patients with syrinx was available for 75% of patients (n = 30/50) and not available for 25% of patients (n = 10/40). Syrinx was diminished in size or resolved in 66.33% of patients (n = 19/30) and the remaining was same for 36.66% of patients (n = 11/30). Conclusions: The main goal of surgery is to arrest the progression of neurological deficits. Foramen magnum decompression with a lax duroplasty is the surgical procedure of choice.


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