caa a22 4500 477107141 CHVBK 20180405111557.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/BF01411256 doi (NATIONALLICENCE)springer-10.1007/BF01411256 The surgical treatment of Chiari I malformation [Elektronische Daten] [J. Klekamp, U. Batzdorf, M. Samii, H. Bothe] Summary: A retrospective study was undertaken on 133 patients with a Chiari I malformation treated within the last 16 years at the Departments of Neurosurgery at the Nordstadt Hospital Hannover, Germany, and the University of California, Los Angeles, U.S.A. Ninety-seven patients presented with symptoms related to accompanying syringomyelia and 4 with associated syringobulbia. They underwent 149 surgical procedures and were followed for a mean of 39±52 months. A decompression at the foramen magnum was performed in 124 patients, while 22 of those with syringomyelia were treated by shunting (7 syringosubarachnoid shunts, 15 syringoperitoneal or -pleural shunts), and 3 by ventriculoperitoneal shunts for hydrocephalus. Except for ventriculoperitoneal shunting, at least a short-term decrease in size of an associated syrinx was observed for all procedures in the majority of cases. However, no long-term benefit was observed for syrinx shunting operations. The best clinical longterm results were obtained with decompression of the foramen magnum in patients with (86% free of a clinical recurrence) and without syringomyelia (77% free of a clinical recurrence). We advise against syrinx shunting, a large craniectomy, and obex plugging which are associated with higher recurrence rates. Instead, surgery should consist of a small craniectomy, opening of the dura, archnoid dissection to establish normal cerebrospinal fluid (CSF) outflow from the 4th ventricle, and a fascia lata durai graft. Springer-Verlag, 1996 Chiari malformation nationallicence syringomyelia nationallicence cerebrospinal fluid nationallicence extracellular fluid nationallicence Klekamp J. Medical School of Hannover, Neurosurgical Clinic, Nordstadt Hospital Hannover, Germany aut Batzdorf U. Division of Neurosurgery, University of California, Los Angeles, CA, USA aut Samii M. Medical School of Hannover, Neurosurgical Clinic, Nordstadt Hospital Hannover, Germany aut Bothe H. Medical School of Hannover, Neurosurgical Clinic, Nordstadt Hospital Hannover, Germany aut Acta Neurochirurgica Springer-Verlag 138/7(1996-07-01), 788-801 0001-6268 138:7<788 1996 138 701 https://doi.org/10.1007/BF01411256 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01411256 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Klekamp J. Medical School of Hannover, Neurosurgical Clinic, Nordstadt Hospital Hannover, Germany aut NATIONALLICENCE 700 1- Batzdorf U. Division of Neurosurgery, University of California, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Samii M. Medical School of Hannover, Neurosurgical Clinic, Nordstadt Hospital Hannover, Germany aut NATIONALLICENCE 700 1- Bothe H. Medical School of Hannover, Neurosurgical Clinic, Nordstadt Hospital Hannover, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/7(1996-07-01), 788-801 0001-6268 138:7<788 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer