Skip to main content

Hindbrain-Related Syringomyelia

  • Chapter
  • First Online:
Syringomyelia

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Notes

  1. 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

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Agrawal A (2008) Sudden unexpected death in a young adult with Chiari I malformation. J Pak Med Assoc 58(7):417–418

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    Google Scholar 

  • Batzdorf U, Klekamp J, Johnson JP (1998) A critical appraisal of syrinx cavity shunting procedures. J Neurosurg 89(3):382–388

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Charney EB, Rorke LB, Sutton LN et al (1987) Management of Chiari II complications in infants with myelomeningocele. J Pediatr 111(3):364–371

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • Danzer E, Johnson MP, Adzick NS (2011) Fetal surgery for myelomeningocele: progress and perspectives. Dev Med Child Neurol 54(1):8–14

    PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Ellenbogen RG, Armonda RA, Shaw DW et al (2000) Toward a rational treatment of Chiari I malformation and syringomyelia. Neurosurg Focus 8(3):E6

    CAS  PubMed  Google Scholar 

  • Elton S, Tubbs RS, Wellons JC 3rd et al (2002) Acute hydrocephalus following a Chiari I decompression. Pediatr Neurosurg 36(2):101–104

    PubMed  Google Scholar 

  • Filis AK, Moon K, Cohen AR (2009) Symptomatic subdural hygroma and hydrocephalus following Chiari I decompression. Pediatr Neurosurg 45(6):425–428

    PubMed  Google Scholar 

  • Fischer EG (1995) Posterior fossa decompression for Chiari I deformity, including resection of the cerebellar tonsils. Childs Nerv Syst 11(11):625–629

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  Google Scholar 

  • Gardner WJ (1965) Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J Neurol Neurosurg Psychiatry 28:247–259

    CAS  PubMed Central  PubMed  Google Scholar 

  • Goel A (2004) Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation. J Neurosurg Spine 1(3):281–286

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Guo F, Wang M, Long J et al (2007) Surgical management of Chiari malformation: analysis of 128 cases. Pediatr Neurosurg 43(5):375–381

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  PubMed Central  PubMed  Google Scholar 

  • Hobbs WR, Sponseller PD, Weiss AP et al (1997) The cervical spine in Marfan syndrome. Spine 22(9):983–989

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Holly LT, Batzdorf U (2001) Management of cerebellar ptosis following craniovertebral decompression for Chiari I malformation. J Neurosurg 94(1):21–26

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • Ishak BA, McLone D, Seleny FL (1980) Intraoperative autonomic dysfunction associated with Arnold-Chiari malformation. Childs Brain 7(3):146–149

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • Klekamp J, Samii M (2001) Syringomyelia – diagnosis and treatment. Springer, Heidelberg

    Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    CAS  Google Scholar 

  • Klekamp J, Batzdorf U, Samii M et al (1996) The surgical treatment of Chiari I malformation. Acta Neurochir (Wien) 138(7):788–801

    CAS  Google Scholar 

  • Klekamp J, Iaconetta G, Batzdorf U et al (2002) Syringomyelia associated with foramen magnum arachnoiditis. J Neurosurg Spine 97(3):317–322

    Google Scholar 

  • Krauss WE, Bledsoe JM, Clarke MJ et al (2010) Rheumatoid arthritis of the craniovertebral junction. Neurosurgery 66(3 Suppl):83–95

    PubMed  Google Scholar 

  • Kumar A, Patni AH, Charbel F (2002) The Chiari I malformation and the neurotologist. Otol Neurotol 23(5):727–735

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Logue V, Edwards MR (1981) Syringomyelia and its surgical treatment – an analysis of 75 patients. J Neurol Neurosurg Psychiatry 44(4):273–284

    CAS  PubMed Central  PubMed  Google Scholar 

  • Marin-Padilla M, Marin-Padilla TM (1981) Morphogenesis of experimentally induced Arnold–Chiari malformation. J Neurol Sci 50(1):29–55

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Mazzola CA, Fried AH (2003) Revision surgery for Chiari malformation decompression. Neurosurg Focus 15(3):E3

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • McLone DG, Knepper PA (1989) The cause of Chiari II malformation: a unified theory. Pediatr Neurosci 15(1):1–12

    CAS  PubMed  Google Scholar 

  • Menezes AH (1991) Chiari I malformations and hydromyelia – complications. Pediatr Neurosurg 17(3):146–154

    PubMed  Google Scholar 

  • Menezes AH (2008a) Specific entities affecting the craniocervical region: Down’s syndrome. Childs Nerv Syst 24(10):1165–1168

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Milhorat TH, Kotzen RM, Mu HT et al (1996) Dysesthetic pain in patients with syringomyelia. Neurosurgery 38(5):940–946; discussion 946–947

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • Nyland H, Krogness KG (1978) Size of posterior fossa in Chiari type 1 malformation in adults. Acta Neurochir (Wien) 40(3–4):233–242

    CAS  Google Scholar 

  • Panigrahi M, Reddy BP, Reddy AK et al (2004) CSF flow study in Chiari I malformation. Childs Nerv Syst 20(5):336–340

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Payner TD, Prenger E, Berger TS et al (1994) Acquired Chiari malformations: incidence, diagnosis, and management. Neurosurgery 34(3):429–434; discussion 434

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Rauzzino M, Oakes WJ (1995) Chiari II malformation and syringomyelia. Neurosurg Clin N Am 6(2):293–309

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Sacco D, Scott RM (2003) Reoperation for Chiari malformations. Pediatr Neurosurg 39(4):171–178

    PubMed  Google Scholar 

  • 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

    CAS  Google Scholar 

  • Schijman E, Steinbok P (2004) International survey on the management of Chiari I malformation and syringomyelia. Childs Nerv Syst 20(5):341–348

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    CAS  Google Scholar 

  • Smith JS, Shaffrey CI, Abel MF et al (2010) Basilar invagination. Neurosurgery 66(3 Suppl):39–47

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Teo C, Parker EC, Aureli S et al (1997) The Chiari II malformation: a surgical series. Pediatr Neurosurg 27(5):223–229

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Tubbs RS, McGirt MJ, Oakes WJ (2003) Surgical experience in 130 pediatric patients with Chiari I malformations. J Neurosurg 99(2):291–296

    PubMed  Google Scholar 

  • Tubbs RS, Lyerly MJ, Loukas M et al (2007) The pediatric Chiari I malformation: a review. Childs Nerv Syst 23(11):1239–1250

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Tulipan N, Hernanz-Schulman M, Lowe LH et al (1999) Intrauterine myelomeningocele repair reverses preexisting hindbrain herniation. Pediatr Neurosurg 31(3):137–142

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    CAS  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Williams B (1977) Difficult labour as a cause of communicating syringomyelia. Lancet 2(8028):51–53

    CAS  PubMed  Google Scholar 

  • Williams B (1978) A critical appraisal of posterior fossa surgery for communicating syringomyelia. Brain 101(2):223–250

    CAS  PubMed  Google Scholar 

  • Williams B (1994) A blast against grafts. Br J Neurosurg 8(3):275–278

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Yoshikawa H (2003) Sudden respiratory arrest and Arnold-Chiari malformation. Eur J Paediatr Neurol 7(4):191

    PubMed  Google Scholar 

  • Zerah M (1999) Syringomyelia in children. Neurochirurgie 45(Suppl 1):37–57

    PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

  • 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

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jörg Klekamp .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

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

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-13706-8_10

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-72484-1

  • Online ISBN: 978-3-642-13706-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics