Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery: Clinical article

David Benglis, Derek Covington, Ritwik Bhatia, Sanjiv Bhatia, Mohamed Elhammady, John Ragheb, Glenn Morrison, David I. Sandberg

Research output: Contribution to journalArticle

43 Citations (Scopus)

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 languageEnglish
Pages (from-to)375-379
Number of pages5
JournalJournal of Neurosurgery: Pediatrics
Volume7
Issue number4
DOIs
StatePublished - Apr 1 2011

Fingerprint

Arnold-Chiari Malformation
Pediatrics
Syringes
Encephalocele
Neurologic Examination

Keywords

  • Chiari malformation type I
  • Pediatric neurosurgery
  • Syringomyelia

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Benglis, D., Covington, D., Bhatia, R., Bhatia, S., Elhammady, M., Ragheb, J., ... Sandberg, D. I. (2011). Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery: Clinical article. Journal of Neurosurgery: Pediatrics, 7(4), 375-379. https://doi.org/10.3171/2011.1.PEDS10341

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 journalArticle

Benglis, D, Covington, D, Bhatia, R, Bhatia, S, Elhammady, M, Ragheb, J, Morrison, G & Sandberg, DI 2011, 'Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery: Clinical article', Journal of Neurosurgery: Pediatrics, vol. 7, no. 4, pp. 375-379. https://doi.org/10.3171/2011.1.PEDS10341
Benglis, David ; Covington, Derek ; Bhatia, Ritwik ; Bhatia, Sanjiv ; Elhammady, Mohamed ; Ragheb, John ; Morrison, Glenn ; Sandberg, David I. / Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery : Clinical article. In: Journal of Neurosurgery: Pediatrics. 2011 ; Vol. 7, No. 4. pp. 375-379.
@article{ffb66de7d6ba4f6da46fe8f967f615cb,
title = "Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery: Clinical article",
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.",
keywords = "Chiari malformation type I, Pediatric neurosurgery, Syringomyelia",
author = "David Benglis and Derek Covington and Ritwik Bhatia and Sanjiv Bhatia and Mohamed Elhammady and John Ragheb and Glenn Morrison and Sandberg, {David I.}",
year = "2011",
month = "4",
day = "1",
doi = "10.3171/2011.1.PEDS10341",
language = "English",
volume = "7",
pages = "375--379",
journal = "Journal of Neurosurgery: Pediatrics",
issn = "1933-0707",
publisher = "American Association of Neurological Surgeons",
number = "4",

}

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 -