Abstract
Background
Specific symptom outcomes after craniovertebral decompression for patients with Chiari type 1 malformation, without accompanying syringomyelia, are not well characterised and poorly reported.
Methods
We performed a retrospective review of all patients diagnosed with Chiari type 1, without syringomyelia, who underwent craniovertebral decompression in our unit.
Results
We identified 129 individuals with a minimum of 2 years’ follow-up. The most common pre-operative symptoms were pressure dissociation headaches (78%), visual disturbances (33%), dizziness/balance disturbances (24%) and blackouts (17%). The symptoms most likely to respond to surgery included Valsalva-induced headache (74% response, p < 0.0001) and blackouts (86% response, p < 0.001).
Conclusions
After successful craniovertebral decompression, most patients presenting with pressure dissociation headaches and blackouts will improve. However, the large variety of other symptoms patients often present with may not improve after surgery.
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Abbreviations
- CSF:
-
Cerebrospinal fluid
- CCOS:
-
Chicago Chiari Outcome Scale
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Joshua Pepper and Ahmed Elhabal. The first draft of the manuscript was written by Joshua Pepper and all authors commented on or revised previous versions of the manuscript. All authors read and approved the final manuscript.
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This article is part of the Topical Collection on CSF Circulation
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Pepper, J., Elhabal, A., Tsermoulas, G. et al. Symptom outcome after craniovertebral decompression for Chiari type 1 malformation without syringomyelia. Acta Neurochir 163, 239–244 (2021). https://doi.org/10.1007/s00701-020-04631-z
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DOI: https://doi.org/10.1007/s00701-020-04631-z