Suboccipital craniectomy with opening of the fourth ventricle and duraplasty: study of 192 cases of craniovertebral malformations

Arquivos de Neuro-Psiquiatria

Jose Alberto Goncalves Da Silva¹  Adailton Arcanjo Dos Santos Jr.¹  Maria Do Desterro Leiros Da Costa¹  Everardo Bandeira De Almeida¹ 

关键词: basilar impression;    Chiari malformation;    hindbrain herniation;    craniovertebral decompression;    syringomyelia;    impressao basilar;    malformacao de Chiari;    herniacao rombencefalica;    descompressao craniovertebral;    siringomielia;   

DOI  :  10.1590/0004-282X20130105

来源: SciELO

【 摘 要 】

The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM), and/or syringomyelia (SM) is based on restoration of the normal cerebrospinal fluid (CSF) dynamics at the craniovertebral junction and creation of a large artificial cisterna magna, avoiding the caudal migration of the hindbrain. It is observed that a large craniectomy might facilitate an upward migration of the posterior fossa structures. There are many surgical techniques to decompress the posterior fossa; however, a gold standard approach remains unclear. The authors present the results of 192 cases of BI, CM, and SM treated between 1975 and 2008 and whose surgical treatment was characterized by a large craniectomy without tonsillectomy with the patient in the sitting position, large opening of the fourth ventricle, and duraplasty.

【 授权许可】

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