Cerebrospinal fluid flow impairment in the patients with Chiari malformation: predictors of syringomyeliа cysts development and dynamics of postoperative regression

Authors

  • L.A. Ktrakyan Uzhhorod National University, Uzhhorod, Ukraine, Ukraine
  • T.S. Havryliv Uzhhorod National University, Uzhhorod, Ukraine, Ukraine
  • V.I. Smolanka Uzhhorod National University, Uzhhorod, Ukraine, Ukraine
  • A.V. Smolanka Uzhhorod National University, Uzhhorod, Ukraine, Ukraine
  • M.M. Oros Uzhhorod National University, Uzhhorod, Ukraine, Ukraine

DOI:

https://doi.org/10.22141/2224-0713.17.6.2021.242233

Keywords:

syringomyelia, Chiari malformation, cerebrospinal fluid circulation, craniovertebral decompression, McRae line, posterior cranial fossa, cine magnetic resonance imaging

Abstract

Background. Chiari malformation (CM) is a defect in the development of the central nervous system, manifested by the mismatch between the size of the posterior cranial fossa and the brain structures located in this area, and, as a consequence, by the descent of the cerebellar tonsils (CM type 1), usually with a caudal dislocation of the lower parts of the brainstem into the foramen magnum (CM type 1.5). As a result of cerebrospinal fluid (CSF) flow disorders, 60–90 % of patients with CM have syringomyelia. Materials and methods. A retrospective analysis was performed of clinical records of 24 patients with Chiari malformation types 1 and 1.5, who had undergone surgeries at the Uzhhorod Regional Clinical Center of Neurosurgery and Neurology from December 2006 to December 2017, during which suboccipital decompressive craniectomy, C1 laminectomy, duraplasty were performed. The average follow-up period after the surgery was 5 years. Results. In patients whose symptoms lasted for more than 3 years, the frequency of formation of the associated syrinxes was 57 %. The dynamics of the regression of CSF flow disorders in the postoperative period varies considerably depending on age. Conclusions. The risk of syrinx formation within the spinal cord is higher in patients with CM types 1 and 1.5 who have been ill for more than 3 years. Surgical treatment is an effective method used to correct CSF circulation disturbances. The cyst puncture is not obligatory during surgical interventions.

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Published

2021-11-23

Issue

Section

Original Researches