Abstract
Introduction
Chiari malformations are characterized by hindbrain herniation. Historically, some types have been linked to neural tube defects, but the causal relationship between the two conditions is still unclear.
Case report
We report on a full-term male neonate with a prenatally diagnosed posterior thoracic meningocele, whose MRI demonstrated Chiari malformation. The meningocele was closed in the second week of life. The Chiari-related symptoms rapidly improved following surgery. Postoperative MRI at 7 months of age showed ascent of the cerebellar tonsils to a normal position.
Discussion
This case suggests that the traction on the cerebellum by a fixed spinal cord may play a role in the pathogenesis of the multifaceted Chiari malformations.
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References
Chiari H (1891) Concerning changes in the cerebellum due to hydrocephalus of the cerebrum (translated). Arch Neurol 25:377–379
Bejjani GK (2001) Definition of the adult Chiari malformation: a brief historical overview. Neurosurg Focus 11:1–8
Tubbs RS, Iskandar BJ, Bartolucci AA, Oakes WJ (2004) A critical analysis of the Chiari 1.5 malformation. J Neurosurg Pediatr 101:179–183
Iskandar BJ, Oakes WJ (1999) Chiari malformations. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and practice of pediatric neurosurgery. Thieme, New York
Penfield W, Coburn DF (1938) Arnold–Chiari malformation and its operative treatment. Arch Neurol Psychiatry 40:328–336
Goldstein F, Kepes JJ (1966) The role of traction in the development of the Arnold–Chiari malformation: an experimental study. J Neuropathol Exp Neurol 25:654–666
Tubbs RS, Loukas M, Shoja MM, Oakes WJ (2007) Observations at the craniocervical junction with simultaneous caudal traction of the spinal cord. Childs Nerv Syst 23:367–369
Barry A, Patten BM, Stewart BH (1957) Possible factors in the development of the Arnold–Chiari malformation. J Neurosurg 14:285–301
Milhorat T, Nishikawa M, Kula R, Dlugacz Y (2010) Mechanisms of cerebellar tonsil herniation in patients with Chiari malformations as guide to clinical management. Acta Neurochir (Wien) 152:1117–1127
McLone D, Knepper P (1989) The cause of Chiari II malformation: a unified theory. Pediatr Neurosci 15:1–12
Royo-Salvador MB, Solé-Llenas J, Doménech JM, González-Adrio R (2005) Results of the section of the filum terminale in 20 patients with syringomyelia, scoliosis and Chiari malformation. Acta Neurochir (Wien) 147:515–523
Milhorat TH, Bolognese PA, Nishikawa M, Francomano CA, McDonnell NB, Roonprapunt C, Kula RW (2009) Association of Chiari malformation type I and tethered cord syndrome: preliminary results of sectioning filum terminale. Surg Neurol 72:20–35
Batty R, Vitta L, Whitby EH, Griffiths PD (2012) Is there a causal relationship between open spinal dysraphism and Chiari II deformity?: a study using in utero magnetic resonance imaging of the fetus. Neurosurgery 70:890–899
Madhok R, Mazzola CA, Pollack IF (2002) Resolution of Chiari malformation after repair of a congenital thoracic meningocele: case report and literature review. Neurosurgery 51:1489–1492
Arts MP, de Jong THR (2004) Thoracic meningocele, meningomyelocele or myelocystocele? Diagnostic difficulties, consequent implications and treatment. Pediatr Neurosurg 40:75–79
McComb JG (1999) Spinal meningoceles. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and practice of pediatric neurosurgery. Thieme, New York
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Chen, J.A., Lazareff, J.A. Correction of Chiari malformation due to closure of a concomitant thoracic meningocele. Childs Nerv Syst 30, 531–534 (2014). https://doi.org/10.1007/s00381-013-2250-1
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DOI: https://doi.org/10.1007/s00381-013-2250-1