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Treatment of Chiari type I malformation in children: the experience of Lyon

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Abstract

The Chiari I malformation represents a complex disease and its pathophysiology is not completely understood and consequently different surgical procedures have been proposed in the literature. The use of MRI have increased the diagnosis of Chiari I malformation but generally the Chiari I is characterized by the herniation of tonsils at 5 mm below the plane of the occipital hole. The consequent disturbance of the CSF circulation at the level of the cranio-vertebral junction favors the occurence of the syrinx between 20 and 70% of cases in pediatric series. Different surgical techniques have been proposed. We report two series of patients treated with the same surgical procedure except for the use of a Goretex dural patch in the second group with better clinical results. Our experience seems to confirm that the Chiari I malformation is a complex disease in which the impairment of the CSF circulation plays an important role to explain the severity of the clinical picture. The bone decompression and the restauration of the CSF circulation with a dural patch with Goretex seems to be effective for improving the clinical picture with good results.

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Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. Service of Pediatric Neurosurgery, Neurosurgical and Neurological Hospital “P. Wertheimer “, Lyon, France

    Carmine Mottolese, Alexandru Szathmari, Emile Simon, Christophe Rousselle, Anne-Claire Ricci-Franchi & M. Hermier

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  1. Carmine Mottolese
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  2. Alexandru Szathmari
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  3. Emile Simon
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  4. Christophe Rousselle
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  5. Anne-Claire Ricci-Franchi
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  6. M. Hermier
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Correspondence to Carmine Mottolese.

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Mottolese, C., Szathmari, A., Simon, E. et al. Treatment of Chiari type I malformation in children: the experience of Lyon. Neurol Sci 32 (Suppl 3), 325–330 (2011). https://doi.org/10.1007/s10072-011-0685-2

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