Abstract
Object. The natural history of untreated Chiari malformation Type I (CM-I) is poorly defined. The object of this study was to investigate outcomes in pediatric patients with CM-I who were followed up without surgical intervention. Methods. The authors retrospectively reviewed 124 cases involving patients with CM-I who presented between July 1999 and July 2008 and were followed up without surgery. The patients ranged in age from 0.9 to 19.8 years (mean 7 years). The duration of follow-up ranged from 1.0 to 8.6 years (mean 2.83 years). Imaging findings, symptoms, and findings on neurological examinations were noted at presentation and for the duration of follow-up. Results. The mean extent of tonsillar herniation at presentation was 8.35 mm (range 5-22 mm). Seven patients had a syrinx at presentation. The syrinx size did not change in these patients on follow-up imaging studies. No new syrinxes developed in the remaining patients who underwent subsequent imaging. The total number of patients with presenting symptoms was 81. Of those 81 patients, 67 demonstrated symptoms that were not typical of CM-I. Of the 14 patients with symptoms attributed to CM-I, 9 had symptoms that were not severe or frequent enough to warrant surgery, and surgery was recommended in the remaining 5 patients. Chiari malformation Type I was also diagnosed in 43 asymptomatic patients who had imaging studies performed for various reasons. No new neurological deficits were noted in any patient for the duration of follow-up. Conclusions. The majority of patients with CM-I who are followed up without surgery do not progress clinically or radiologically. Longer follow-up of this cohort will be required to determine if symptoms or new neurological findings develop over the course of many years.
| Original language | English |
|---|---|
| Pages (from-to) | 375-379 |
| Number of pages | 5 |
| Journal | Journal of Neurosurgery: Pediatrics |
| Volume | 7 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2011 |
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Keywords
- Chiari malformation type I
- Pediatric neurosurgery
- Syringomyelia
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery : Clinical article. / Benglis, David; Covington, Derek; Bhatia, Ritwik; Bhatia, Sanjiv; Elhammady, Mohamed; Ragheb, John; Morrison, Glenn; Sandberg, David I.
In: Journal of Neurosurgery: Pediatrics, Vol. 7, No. 4, 01.04.2011, p. 375-379.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery
T2 - Clinical article
AU - Benglis, David
AU - Covington, Derek
AU - Bhatia, Ritwik
AU - Bhatia, Sanjiv
AU - Elhammady, Mohamed
AU - Ragheb, John
AU - Morrison, Glenn
AU - Sandberg, David I.
PY - 2011/4/1
Y1 - 2011/4/1
N2 - Object. The natural history of untreated Chiari malformation Type I (CM-I) is poorly defined. The object of this study was to investigate outcomes in pediatric patients with CM-I who were followed up without surgical intervention. Methods. The authors retrospectively reviewed 124 cases involving patients with CM-I who presented between July 1999 and July 2008 and were followed up without surgery. The patients ranged in age from 0.9 to 19.8 years (mean 7 years). The duration of follow-up ranged from 1.0 to 8.6 years (mean 2.83 years). Imaging findings, symptoms, and findings on neurological examinations were noted at presentation and for the duration of follow-up. Results. The mean extent of tonsillar herniation at presentation was 8.35 mm (range 5-22 mm). Seven patients had a syrinx at presentation. The syrinx size did not change in these patients on follow-up imaging studies. No new syrinxes developed in the remaining patients who underwent subsequent imaging. The total number of patients with presenting symptoms was 81. Of those 81 patients, 67 demonstrated symptoms that were not typical of CM-I. Of the 14 patients with symptoms attributed to CM-I, 9 had symptoms that were not severe or frequent enough to warrant surgery, and surgery was recommended in the remaining 5 patients. Chiari malformation Type I was also diagnosed in 43 asymptomatic patients who had imaging studies performed for various reasons. No new neurological deficits were noted in any patient for the duration of follow-up. Conclusions. The majority of patients with CM-I who are followed up without surgery do not progress clinically or radiologically. Longer follow-up of this cohort will be required to determine if symptoms or new neurological findings develop over the course of many years.
AB - Object. The natural history of untreated Chiari malformation Type I (CM-I) is poorly defined. The object of this study was to investigate outcomes in pediatric patients with CM-I who were followed up without surgical intervention. Methods. The authors retrospectively reviewed 124 cases involving patients with CM-I who presented between July 1999 and July 2008 and were followed up without surgery. The patients ranged in age from 0.9 to 19.8 years (mean 7 years). The duration of follow-up ranged from 1.0 to 8.6 years (mean 2.83 years). Imaging findings, symptoms, and findings on neurological examinations were noted at presentation and for the duration of follow-up. Results. The mean extent of tonsillar herniation at presentation was 8.35 mm (range 5-22 mm). Seven patients had a syrinx at presentation. The syrinx size did not change in these patients on follow-up imaging studies. No new syrinxes developed in the remaining patients who underwent subsequent imaging. The total number of patients with presenting symptoms was 81. Of those 81 patients, 67 demonstrated symptoms that were not typical of CM-I. Of the 14 patients with symptoms attributed to CM-I, 9 had symptoms that were not severe or frequent enough to warrant surgery, and surgery was recommended in the remaining 5 patients. Chiari malformation Type I was also diagnosed in 43 asymptomatic patients who had imaging studies performed for various reasons. No new neurological deficits were noted in any patient for the duration of follow-up. Conclusions. The majority of patients with CM-I who are followed up without surgery do not progress clinically or radiologically. Longer follow-up of this cohort will be required to determine if symptoms or new neurological findings develop over the course of many years.
KW - Chiari malformation type I
KW - Pediatric neurosurgery
KW - Syringomyelia
UR - http://www.scopus.com/inward/record.url?scp=79953817453&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79953817453&partnerID=8YFLogxK
U2 - 10.3171/2011.1.PEDS10341
DO - 10.3171/2011.1.PEDS10341
M3 - Article
C2 - 21456908
AN - SCOPUS:79953817453
VL - 7
SP - 375
EP - 379
JO - Journal of Neurosurgery: Pediatrics
JF - Journal of Neurosurgery: Pediatrics
SN - 1933-0707
IS - 4
ER -