Abstract
This chapter deals with the anatomical abnormalities, neuroradiology, clinical presentation and surgical management of hindbrain-related syringomyelia including Chiari I malformation, basilar invagination, Chiari II malformation and foramen magnum arachnoiditis. The results and complications of different surgical techniques are reviewed, and the author’s experience in dealing with recurrences and surgical revisions is shared.
Notes
- 1.
The reappearance or progression of preoperative symptoms, or development of new neurological symptoms, related to the Chiari or the syrinx
References
Abe T, Okuda Y, Nagashima H et al (1995) Surgical treatment of syringomyelia. Rinsho Shinkeigaku 35(12):1406–1408
Aboulezz AO, Sartor K, Geyer CA et al (1985) Position of cerebellar tonsils in the normal population and in patients with Chiari malformation: a quantitative approach with MR imaging. J Comput Assist Tomogr 9(6):1033–1036
Aghakhani N, Parker F, Tadie M (1999) Syringomyelia and Chiari abnormality in the adult. Analysis of the results of a cooperative series of 285 cases. Neurochirurgie 45(Suppl 1):23–36
Aghakhani N, Parker F, David P et al (2009) Long-term follow-up of Chiari-related syringomyelia in adults: analysis of 157 surgically treated cases. Neurosurgery 64(2):308–315; discussion 315
Agrawal A (2008) Sudden unexpected death in a young adult with Chiari I malformation. J Pak Med Assoc 58(7):417–418
Aoki N, Oikawa A, Sakai T (1995) Spontaneous regeneration of the foramen magnum after decompressive suboccipital craniectomy in Chiari malformation: case report. Neurosurgery 37(2):340–342
Appleby A, Bradley WG, Foster JB et al (1969) Syringomyelia due to chronic arachnoiditis at the foramen magnum. J Neurol Sci 8(3):451–464
Armonda RA, Citrin CM, Foley KT et al (1994) Quantitative cine-mode magnetic resonance imaging of Chiari I malformations: an analysis of cerebrospinal fluid dynamics. Neurosurgery 35(2):214–223; discussion 223–224
Attenello FJ, McGirt MJ, Gathinji M et al (2008) Outcome of Chiari-associated syringomyelia after hindbrain decompression in children: analysis of 49 consecutive cases. Neurosurgery 62(6):1307–1313; discussion 1313
Attenello FJ, McGirt MJ, Garces-Ambrossi GL et al (2009) Suboccipital decompression for Chiari I malformation: outcome comparison of duraplasty with expanded polytetrafluoroethylene dural substitute versus pericranial autograft. Childs Nerv Syst 25(2):183–190
Badie B, Mendoza D, Batzdorf U (1995) Posterior fossa volume and response to suboccipital decompression in patients with Chiari I malformation. Neurosurgery 37(2):214–218
Bahl A, Murphy M, Thomas N et al (2011) Management of infratentorial subdural hygroma complicating foramen magnum decompression: a report of three cases. Acta Neurochir (Wien) 153(5):1123–1128
Batzdorf U, Klekamp J, Johnson JP (1998) A critical appraisal of syrinx cavity shunting procedures. J Neurosurg 89(3):382–388
Bhadelia RA, Bogdan AR, Wolpert SM et al (1995) Cerebrospinal fluid flow waveforms: analysis in patients with Chiari I malformation by means of gated phase-contrast MR imaging velocity measurements. Radiology 196(1):195–202
Boyles AL, Enterline DS, Hammock PH et al (2006) Phenotypic definition of Chiari type I malformation coupled with high-density SNP genome screen shows significant evidence for linkage to regions on chromosomes 9 and 15. Am J Med Genet A 140(24):2776–2785. doi:10.1002/ajmg.a.31546
Caldarelli M, Novegno F, Vassimi L et al (2007) The role of limited posterior fossa craniectomy in the surgical treatment of Chiari malformation Type I: experience with a pediatric series. J Neurosurg 106(3 Suppl):187–195
Charney EB, Rorke LB, Sutton LN et al (1987) Management of Chiari II complications in infants with myelomeningocele. J Pediatr 111(3):364–371
Chauvet D, Carpentier A, George B (2009) Dura splitting decompression in Chiari type 1 malformation: clinical experience and radiological findings. Neurosurg Rev 32(4):465–470
Chiari H (1896) Über Veränderungen des Kleinhirns, des Pons und der Medulla oblongata infolge congenitaler Hydrocephalie des Grosshirns. Denkschr Akad Wiss Wien 63:71–116
Chumas PD, Armstrong DC, Drake JM et al (1993) Tonsillar herniation: the rule rather than the exception after lumboperitoneal shunting in the pediatric population. J Neurosurg 78(4):568–573
Danzer E, Johnson MP, Adzick NS (2011) Fetal surgery for myelomeningocele: progress and perspectives. Dev Med Child Neurol 54(1):8–14
Di Lorenzo N, Palma L, Palatinsky E et al (1995) “Conservative” cranio-cervical decompression in the treatment of syringomyelia-Chiari I complex. A prospective study of 20 adult cases. Spine 20(23):2479–2483
Dubey A, Sung WS, Shaya M et al (2009) Complications of posterior cranial fossa surgery – an institutional experience of 500 patients. Surg Neurol 72(4):369–375
Durham SR, Fjeld-Olenec K (2008) Comparison of posterior fossa decompression with and without duraplasty for the surgical treatment of Chiari malformation Type I in pediatric patients: a meta-analysis. J Neurosurg Pediatr 2(1):42–49
Elgamal EA, El-Dawlatly AA, Murshid WR et al (2011) Endoscopic third ventriculostomy for hydrocephalus in children younger than 1 year of age. Childs Nerv Syst 27(1):111–116
Ellenbogen RG, Armonda RA, Shaw DW et al (2000) Toward a rational treatment of Chiari I malformation and syringomyelia. Neurosurg Focus 8(3):E6
Elton S, Tubbs RS, Wellons JC 3rd et al (2002) Acute hydrocephalus following a Chiari I decompression. Pediatr Neurosurg 36(2):101–104
Filis AK, Moon K, Cohen AR (2009) Symptomatic subdural hygroma and hydrocephalus following Chiari I decompression. Pediatr Neurosurg 45(6):425–428
Fischer EG (1995) Posterior fossa decompression for Chiari I deformity, including resection of the cerebellar tonsils. Childs Nerv Syst 11(11):625–629
Galarza M, Sood S, Ham S (2007) Relevance of surgical strategies for the management of pediatric Chiari type I malformation. Childs Nerv Syst 23(6):691–696
Galarza M, Lopez-Guerrero AL, Martinez-Lage JF (2010) Posterior fossa arachnoid cysts and cerebellar tonsillar descent: short review. Neurosurg Rev 33(3):305–314; discussion 314
Gambardella G, Caruso G, Caffo M et al (1998) Transverse microincisions of the outer layer of the dura mater combined with foramen magnum decompression as treatment for syringomyelia with Chiari I malformation. Acta Neurochir (Wien) 140(2):134–139
Gardner WJ (1965) Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J Neurol Neurosurg Psychiatry 28:247–259
Goel A (2004) Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation. J Neurosurg Spine 1(3):281–286
Goel A, Shah A (2009) Reversal of longstanding musculoskeletal changes in basilar invagination after surgical decompression and stabilization. J Neurosurg Spine 10(3):220–227
Guo F, Wang M, Long J et al (2007) Surgical management of Chiari malformation: analysis of 128 cases. Pediatr Neurosurg 43(5):375–381
Guyotat J, Bret P, Mottolese C et al (1997) Chiari I malformation with syringomyelia treated by decompression of the cranio-spinal junction and tonsillectomy. Apropos of 8 cases. Neurochirurgie 43(3):135–141
Guyotat J, Bret P, Jouanneau E et al (1998) Syringomyelia associated with type I Chiari malformation. A 21-year retrospective study on 75 cases treated by foramen magnum decompression with a special emphasis on the value of tonsils resection. Acta Neurochir (Wien) 140(8):745–754
Haroun RI, Guarnieri M, Meadow JJ et al (2000) Current opinions for the treatment of syringomyelia and Chiari malformations: survey of the Pediatric Section of the American Association of Neurological Surgeons. Pediatr Neurosurg 33(6):311–317
Haughton VM, Korosec FR, Medow JE et al (2003) Peak systolic and diastolic CSF velocity in the foramen magnum in adult patients with Chiari I malformations and in normal control participants. AJNR Am J Neuroradiol 24(2):169–176
Hayhurst C, Richards O, Zaki H et al (2008) Hindbrain decompression for Chiari – syringomyelia complex: an outcome analysis comparing surgical techniques. Br J Neurosurg 22(1):86–91
Henriques Filho PS, Pratesi R (2006) Abnormalities in auditory evoked potentials of 75 patients with Arnold-Chiari malformations types I and II. Arq Neuropsiquiatr 64(3A):619–623
Hida K, Iwasaki Y, Imamura H et al (1994) Birth injury as a causative factor of syringomyelia with Chiari type I deformity. J Neurol Neurosurg Psychiatry 57(3):373–374
Hobbs WR, Sponseller PD, Weiss AP et al (1997) The cervical spine in Marfan syndrome. Spine 22(9):983–989
Hoffman CE, Souweidane MM (2008) Cerebrospinal fluid-related complications with autologous duraplasty and arachnoid sparing in type I Chiari malformation. Neurosurgery 62(3 Suppl 1):156–160; discussion 160–161
Hofkes SK, Iskandar BJ, Turski PA et al (2007) Differentiation between symptomatic Chiari I malformation and asymptomatic tonsilar ectopia by using cerebrospinal fluid flow imaging: initial estimate of imaging accuracy. Radiology 245(2):532–540
Holly LT, Batzdorf U (2001) Management of cerebellar ptosis following craniovertebral decompression for Chiari I malformation. J Neurosurg 94(1):21–26
Hudgins RJ, Boydston WR (1995) Bone regrowth and recurrence of symptoms following decompression in the infant with Chiari II malformation. Pediatr Neurosurg 23(6):323–327
Ishak BA, McLone D, Seleny FL (1980) Intraoperative autonomic dysfunction associated with Arnold-Chiari malformation. Childs Brain 7(3):146–149
James HE, Brant A (2002) Treatment of the Chiari malformation with bone decompression without durotomy in children and young adults. Childs Nerv Syst 18(5):202–206
Jian FZ, Chen Z, Wrede KH et al (2010) Direct posterior reduction and fixation for the treatment of basilar invagination with atlantoaxial dislocation. Neurosurgery 66(4):678–687; discussion 687
Kagawa M, Jinnai T, Matsumoto Y et al (2006) Chiari I malformation accompanied by assimilation of the atlas, Klippel-Feil syndrome, and syringomyelia: case report. Surg Neurol 65(5):497–502; discussion 502
Kandasamy J, Kneen R, Gladstone M et al (2008) Chiari I malformation without hydrocephalus: acute intracranial hypertension managed with endoscopic third ventriculostomy (ETV). Childs Nerv Syst 24(12):1493–1497
Kirsch WM, Duncan BR, Black FO et al (1968) Laryngeal palsy in association with myelomeningocele, hydrocephalus, and the Arnold-Chiari malformation. J Neurosurg 28(3):207–214
Klekamp J, Samii M (2001) Syringomyelia – diagnosis and treatment. Springer, Heidelberg
Klekamp J, Riedel A, Harper C et al (1989) Morphometric study on the postnatal growth of non-cortical brain regions in Australian aborigines and Caucasians. Brain Res 485(1):79–88
Klekamp J, Samii M, Tatagiba M et al (1995) Syringomyelia in association with tumours of the posterior fossa. Pathophysiological considerations, based on observations on three related cases. Acta Neurochir (Wien) 137(1–2):38–43
Klekamp J, Batzdorf U, Samii M et al (1996) The surgical treatment of Chiari I malformation. Acta Neurochir (Wien) 138(7):788–801
Klekamp J, Iaconetta G, Batzdorf U et al (2002) Syringomyelia associated with foramen magnum arachnoiditis. J Neurosurg Spine 97(3):317–322
Krauss WE, Bledsoe JM, Clarke MJ et al (2010) Rheumatoid arthritis of the craniovertebral junction. Neurosurgery 66(3 Suppl):83–95
Kumar A, Patni AH, Charbel F (2002) The Chiari I malformation and the neurotologist. Otol Neurotol 23(5):727–735
Kumar R, Kalra SK, Vaid VK et al (2008) Chiari I malformation: surgical experience over a decade of management. Br J Neurosurg 22(3):409–414
Lam FC, Irwin BJ, Poskitt KJ et al (2009) Cervical spine instability following cervical laminectomies for Chiari II malformation: a retrospective cohort study. Childs Nerv Syst 25(1):71–76
Limonadi FM, Selden NR (2004) Dura-splitting decompression of the craniocervical junction: reduced operative time, hospital stay, and cost with equivalent early outcome. J Neurosurg 101(2 Suppl):184–188
Logue V, Edwards MR (1981) Syringomyelia and its surgical treatment – an analysis of 75 patients. J Neurol Neurosurg Psychiatry 44(4):273–284
Marin-Padilla M, Marin-Padilla TM (1981) Morphogenesis of experimentally induced Arnold–Chiari malformation. J Neurol Sci 50(1):29–55
Marshman LA, Benjamin JC, Chawda SJ et al (2005) Acute obstructive hydrocephalus associated with infratentorial subdural hygromas complicating Chiari malformation Type I decompression. Report of two cases and literature review. J Neurosurg 103(4):752–755
Massimi L, Pravata E, Tamburrini G et al (2011) Endoscopic third ventriculostomy for the management of Chiari I and related hydrocephalus: outcome and pathogenetic implications. Neurosurgery 68(4):950–956. doi:10.1227/NEU.0b013e318208f1f3
Mazzola CA, Fried AH (2003) Revision surgery for Chiari malformation decompression. Neurosurg Focus 15(3):E3
McGirt MJ, Atiba A, Attenello FJ et al (2008a) Correlation of hindbrain CSF flow and outcome after surgical decompression for Chiari I malformation. Childs Nerv Syst 24(7):833–840
McGirt MJ, Attenello FJ, Atiba A et al (2008b) Symptom recurrence after suboccipital decompression for pediatric Chiari I malformation: analysis of 256 consecutive cases. Childs Nerv Syst 24(11):1333–1339
McLone DG, Knepper PA (1989) The cause of Chiari II malformation: a unified theory. Pediatr Neurosci 15(1):1–12
Menezes AH (1991) Chiari I malformations and hydromyelia – complications. Pediatr Neurosurg 17(3):146–154
Menezes AH (2008a) Specific entities affecting the craniocervical region: Down’s syndrome. Childs Nerv Syst 24(10):1165–1168
Menezes AH (2008b) Specific entities affecting the craniocervical region: osteogenesis imperfecta and related osteochondrodysplasias: medical and surgical management of basilar impression. Childs Nerv Syst 24(10):1169–1172
Menezes AH, Greenlee JD, Donovan KA (2005) Honored guest presentation: lifetime experiences and where we are going: Chiari I with syringohydromyelia – controversies and development of decision trees. Clin Neurosurg 52:297–305
Mikulis DJ, Diaz O, Egglin TK et al (1992) Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology 183(3):725–728
Milhorat TH, Bolognese PA (2003) Tailored operative technique for Chiari type I malformation using intraoperative color Doppler ultrasonography. Neurosurgery 53(4):899–905; discussion 905–906
Milhorat TH, Kotzen RM, Mu HT et al (1996) Dysesthetic pain in patients with syringomyelia. Neurosurgery 38(5):940–946; discussion 946–947
Milhorat TH, Chou MW, Trinidad EM et al (1999) Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 44(5):1005–1017
Mottolese C, Szathmari A, Simon E et al (2011) Treatment of Chiari type I malformation in children: the experience of Lyon. Neurol Sci 32(Suppl 3):S325–S330
Munshi I, Frim D, Stine-Reyes R et al (2000) Effects of posterior fossa decompression with and without duraplasty on Chiari malformation-associated hydromyelia. Neurosurgery 46(6):1384–1389; discussion 1389–1390
Murano T, Rella J (2006) Incidental finding of Chiari I malformation with progression of symptoms after head trauma: case report. J Emerg Med 30(3):295–298
Mutchnick IS, Janjua RM, Moeller K et al (2010) Decompression of Chiari malformation with and without duraplasty: morbidity versus recurrence. J Neurosurg Pediatr 5(5):474–478
Navarro R, Olavarria G, Seshadri R et al (2004) Surgical results of posterior fossa decompression for patients with Chiari I malformation. Childs Nerv Syst 20(5):349–356
Nishikawa M, Sakamoto H, Hakuba A, Nakanishi N, Inoue Y (1997) Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa. J Neurosurg 86(1):40–47
Nyland H, Krogness KG (1978) Size of posterior fossa in Chiari type 1 malformation in adults. Acta Neurochir (Wien) 40(3–4):233–242
Panigrahi M, Reddy BP, Reddy AK et al (2004) CSF flow study in Chiari I malformation. Childs Nerv Syst 20(5):336–340
Pare LS, Batzdorf U (1998) Syringomyelia persistence after Chiari decompression as a result of pseudomeningocele formation: implications for syrinx pathogenesis: report of three cases. Neurosurgery 43(4):945–948
Parker SR, Harris P, Cummings TJ et al (2011) Complications following decompression of Chiari malformation Type I in children: dural graft or sealant? J Neurosurg Pediatr 8(2):177–183
Payner TD, Prenger E, Berger TS et al (1994) Acquired Chiari malformations: incidence, diagnosis, and management. Neurosurgery 34(3):429–434; discussion 434
Pollack IF, Pang D, Albright AL et al (1992) Outcome following hindbrain decompression of symptomatic Chiari malformations in children previously treated with myelomeningocele closure and shunts. J Neurosurg 77(6):881–888
Pollack IF, Kinnunen D, Albright AL (1996) The effect of early craniocervical decompression on functional outcome in neonates and young infants with myelodysplasia and symptomatic Chiari II malformations: results from a prospective series. Neurosurgery 38(4):703–710; discussion 710
Rahman M, Perkins LA, Pincus DW (2009) Aggressive surgical management of patients with Chiari II malformation and brainstem dysfunction. Pediatr Neurosurg 45(5):337–344
Rauzzino M, Oakes WJ (1995) Chiari II malformation and syringomyelia. Neurosurg Clin N Am 6(2):293–309
Rosen DS, Wollman R, Frim DM (2003) Recurrence of symptoms after Chiari decompression and duraplasty with nonautologous graft material. Pediatr Neurosurg 38(4):186–190
Sacco D, Scott RM (2003) Reoperation for Chiari malformations. Pediatr Neurosurg 39(4):171–178
Sakamoto H, Nishikawa M, Hakuba A et al (1999) Expansive suboccipital cranioplasty for the treatment of syringomyelia associated with Chiari malformation. Acta Neurochir (Wien) 141(9):949–960; discussion 960–961
Schijman E, Steinbok P (2004) International survey on the management of Chiari I malformation and syringomyelia. Childs Nerv Syst 20(5):341–348
Sindou M, Gimbert E (2009) Decompression for Chiari type I-malformation (with or without syringomyelia) by extreme lateral foramen magnum opening and expansile duraplasty with arachnoid preservation: comparison with other technical modalities (Literature review). Adv Tech Stand Neurosurg 34:85–110
Sindou M, Chavez-Machuca J, Hashish H (2002) Cranio-cervical decompression for Chiari type I-malformation, adding extreme lateral foramen magnum opening and expansile duroplasty with arachnoid preservation. Technique and long-term functional results in 44 consecutive adult cases – comparison with literature dat. Acta Neurochir (Wien) 144(10):1005–1019
Smith JS, Shaffrey CI, Abel MF et al (2010) Basilar invagination. Neurosurgery 66(3 Suppl):39–47
Spena G, Bernucci C, Garbossa D et al (2010) Clinical and radiological outcome of craniocervical osteo-dural decompression for Chiari I-associated syringomyelia. Neurosurg Rev 33(3):297–303; discussion 303–304
Stephany JD, Garavaglia JC, Pearl GS (2008) Sudden death in a 27-year-old man with Chiari I malformation. Am J Forensic Med Pathol 29(3):249–250
Stovner LJ, Bergan U, Nilsen G, Sjaastad O (1993) Posterior cranial fossa dimensions in the Chiari I malformation: relation to pathogenesis and clinical presentation. Neuroradiology 35(2):113–118
Suzuki F, Kitagawa T, Takagi K et al (2011) Subacute subdural hygroma and presyrinx formation after foramen magnum decompression with duraplasty for Chiari type 1 malformation. Neurol Med Chir (Tokyo) 51(5):389–393
Takeuchi K, Yokoyama T, Ito J et al (2007) Tonsillar herniation and the cervical spine: a morphometric study of 172 patients. J Orthop Sci 12(1):55–60
Talamonti G, Zella S (2011) Surgical treatment of CM2 and syringomyelia in a series of 231 myelomeningocele patients. Neurol Sci 32(Suppl 3):S331–S333
Teo C, Parker EC, Aureli S et al (1997) The Chiari II malformation: a surgical series. Pediatr Neurosurg 27(5):223–229
Trigylidas T, Baronia B, Vassilyadi M, Ventureyra EC (2008) Posterior fossa dimension and volume estimates in pediatric patients with Chiari I malformations. Childs Nerv Syst 24(3):329–336
Tubbs RS, Oakes WJ (2004) Treatment and management of the Chiari II malformation: an evidence-based review of the literature. Childs Nerv Syst 20(6):375–381
Tubbs RS, McGirt MJ, Oakes WJ (2003) Surgical experience in 130 pediatric patients with Chiari I malformations. J Neurosurg 99(2):291–296
Tubbs RS, Lyerly MJ, Loukas M et al (2007) The pediatric Chiari I malformation: a review. Childs Nerv Syst 23(11):1239–1250
Tubbs RS, Beckman J, Naftel RP et al (2011) Institutional experience with 500 cases of surgically treated pediatric Chiari malformation Type I. J Neurosurg Pediatr 7(3):248–256
Tulipan N, Hernanz-Schulman M, Lowe LH et al (1999) Intrauterine myelomeningocele repair reverses preexisting hindbrain herniation. Pediatr Neurosurg 31(3):137–142
Valentini L, Visintini S, Saletti V et al (2011) Treatment for Chiari 1 malformation (CIM): analysis of a pediatric surgical series. Neurol Sci 32(Suppl 3):S321–S324
Vanaclocha V, Saiz-Sapena N (1997) Duraplasty with freeze-dried cadaveric dura versus occipital pericranium for Chiari type I malformation: comparative study. Acta Neurochir (Wien) 139(2):112–119
Vandertop WP, Asai A, Hoffman HJ et al (1992) Surgical decompression for symptomatic Chiari II malformation in neonates with myelomeningocele. J Neurosurg 77(4):541–544
Wetjen NM, Heiss JD, Oldfield EH (2008) Time course of syringomyelia resolution following decompression of Chiari malformation Type I. J Neurosurg Pediatr 1(2):118–123
Williams B (1977) Difficult labour as a cause of communicating syringomyelia. Lancet 2(8028):51–53
Williams B (1978) A critical appraisal of posterior fossa surgery for communicating syringomyelia. Brain 101(2):223–250
Williams B (1994) A blast against grafts. Br J Neurosurg 8(3):275–278
Wolf DA, Veasey SP 3rd, Wilson SK et al (1998) Death following minor head trauma in two adult individuals with the Chiari I deformity. J Forensic Sci 43(6):1241–1243
Yanni DS, Mammis A, Ebersole K et al (2010) Revision of Chiari decompression for patients with recurrent syrinx. J Clin Neurosci 17(8):1076–1079
Yarbrough CK, Powers AK, Park TS et al (2011) Patients with Chiari malformation Type I presenting with acute neurological deficits: case series. J Neurosurg Pediatr 7(3):244–247
Yilmaz A, Kanat A, Musluman AM et al (2011) When is duraplasty required in the surgical treatment of Chiari malformation type I based on tonsillar descending grading scale? World Neurosurg 75(2):307–313
Yoshikawa H (2003) Sudden respiratory arrest and Arnold-Chiari malformation. Eur J Paediatr Neurol 7(4):191
Zerah M (1999) Syringomyelia in children. Neurochirurgie 45(Suppl 1):37–57
Zhang ZQ, Chen YQ, Chen YA et al (2008) Chiari I malformation associated with syringomyelia: a retrospective study of 316 surgically treated patients. Spinal Cord 46(5):358–363
Zhang Y, Zhang N, Qiu H et al (2011) An efficacy analysis of posterior fossa decompression techniques in the treatment of Chiari malformation with associated syringomyelia. J Clin Neurosci 18(10):1346–1349
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Klekamp, J. (2014). Hindbrain-Related Syringomyelia. In: Flint, G., Rusbridge, C. (eds) Syringomyelia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-13706-8_10
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