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Posterior Fossa Decompression with or Without Duraplasty for Chiari I Malformation. 2023

Alexander T Yahanda, and David D Limbrick
Department of Neurological Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA. Electronic address: ayahanda@wustl.edu.

Posterior fossa decompression (PFD) with/without duraplasty is the standard surgical treatment for symptomatic CM-1. Posterior fossa decompression without duraplasty (PFD) may be associated with shorter operative times and hospital stays, fewer complications, and may yield improvements in symptoms and syrinx sizes. Posterior fossa decompression with duraplasty (PFDD) may be associated with superior long-term symptomatic improvements, larger syrinx reductions, and a lower need for revision decompression. Various dural graft materials may be used for PFDD, though the ideal type of graft has not been definitively established. Other adjunct surgical procedures may be added to PFD/PFDD given certain symptomatic or anatomical considerations.

UI MeSH Term Description Entries
D004388 Dura Mater The outermost of the three MENINGES, a fibrous membrane of connective tissue that covers the brain and the spinal cord. Falx Cerebelli,Falx Cerebri,Pachymeninx,Tentorium Cerebelli
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001139 Arnold-Chiari Malformation A group of congenital malformations involving the brainstem, cerebellum, upper spinal cord, and surrounding bony structures. Type II is the most common, and features compression of the medulla and cerebellar tonsils into the upper cervical spinal canal and an associated MENINGOMYELOCELE. Type I features similar, but less severe malformations and is without an associated meningomyelocele. Type III has the features of type II with an additional herniation of the entire cerebellum through the bony defect involving the foramen magnum, forming an ENCEPHALOCELE. Type IV is a form a cerebellar hypoplasia. Clinical manifestations of types I-III include TORTICOLLIS; opisthotonus; HEADACHE; VERTIGO; VOCAL CORD PARALYSIS; APNEA; NYSTAGMUS, CONGENITAL; swallowing difficulties; and ATAXIA. (From Menkes, Textbook of Child Neurology, 5th ed, p261; Davis, Textbook of Neuropathology, 2nd ed, pp236-46) Arnold-Chiari Deformity,Arnold-Chiari Malformation, Type 1,Arnold-Chiari Malformation, Type 2,Arnold-Chiari Malformation, Type 3,Arnold-Chiari Malformation, Type 4,Arnold-Chiari Malformation, Type I,Arnold-Chiari Malformation, Type II,Arnold-Chiari Malformation, Type III,Arnold-Chiari Malformation, Type IV,Arnold-Chiari Syndrome,Chiari Malformation Type 2,Chiari Malformation Type I,Chiari Malformation Type II,Malformation, Arnold-Chiari,Type I Arnold-Chiari Malformation,Type II Arnold-Chiari Malformation,Type III Arnold-Chiari Malformation,Type IV Arnold-Chiari Malformation,Arnold Chiari Deformity,Arnold Chiari Malformation,Arnold Chiari Malformation, Type 1,Arnold Chiari Malformation, Type 2,Arnold Chiari Malformation, Type 3,Arnold Chiari Malformation, Type 4,Arnold Chiari Malformation, Type I,Arnold Chiari Malformation, Type II,Arnold Chiari Malformation, Type III,Arnold Chiari Malformation, Type IV,Arnold Chiari Syndrome,Deformity, Arnold-Chiari,Malformation, Arnold Chiari,Syndrome, Arnold-Chiari,Type I Arnold Chiari Malformation,Type II Arnold Chiari Malformation,Type III Arnold Chiari Malformation,Type IV Arnold Chiari Malformation
D013595 Syringomyelia Longitudinal cavities in the spinal cord, most often in the cervical region, which may extend for multiple spinal levels. The cavities are lined by dense, gliogenous tissue and may be associated with SPINAL CORD NEOPLASMS; spinal cord traumatic injuries; and vascular malformations. Syringomyelia is marked clinically by pain and PARESTHESIA, muscular atrophy of the hands, and analgesia with thermoanesthesia of the hands and arms, but with the tactile sense preserved (sensory dissociation). Lower extremity spasticity and incontinence may also develop. (From Adams et al., Principles of Neurology, 6th ed, p1269) Hydrosyringomyelia,Morvan Disease,Morvan's Disease,Myelosyringosis,Syringomyelus,Hydrosyringomyelias,Morvan Diseases,Morvan's Diseases,Morvans Disease,Myelosyringoses,Syringomyelias
D019299 Decompression, Surgical A surgical operation for the relief of pressure in a body compartment or on a body part. (From Dorland, 28th ed) Surgical Decompression,Decompressions, Surgical,Surgical Decompressions

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