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Surgical Management of chiari malformation type 1 in adults /

Amr Abdelmonam Abdelaziz Mostafa

Surgical Management of chiari malformation type 1 in adults / العلاج الجراحى لتشوهات كيارى النوع الاول فى البالغين Amr Abdelmonam Abdelaziz Mostafa ; Supervised Mohamed Shehab Saad Zaghloul , Ahmed Mostafa Kersh , Ehab Abdelhalem - Cairo : Amr Abdelmonam Abdelaziz Mostafa , 2015 - 79 P. : charts , facsimiles ; 25cm

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Patients and methods: This study included 10 patients with chiari malformation type I. Operated in the period between March 2014 to December 2014 at neurosurgery department of Kasr El-Aini Cairo university Hospitals. Data were collected prospectively from the involved patients in the study. All patients were evaluated preoperatively by neurological, ophthalmological and radiological assessment. All patients underwent evaluation by, CT scanning of the brain & skull and MRI imaging of the brain.CT and MRI were done as the routine follow up investigations for all patients.Follow up CT was done after 24 hours for all patients.Follow up MRI was 3 months postoperatively.Extra scans were done for any deteriorating patient.CT showing also any hydrocephalic changes a. Follow up MRI was scheduled at three months postoperativelyIn our study, we operate through midline lower neck inciscion, craniectomy, durotomy in y shaped manner,Shrinkage of cerebellar tonsils by bipolar electrocautry,Duroplasty by fascia lata graft, water tight closure . Results: The mean age at the time of surgery for the studied group was 41.5 years ranging from 18 to 65 years. There was a female predomi»nance .There were 6 females (60%) and 4 males (40%) which provide a female/male ratio of (1.5/1). The most common clini»cal findings presented at diagnosis were headache in 10 patients, neck pain in 9 patients, dizziness and fatigue in 7, extremities numbness and parathesia in 6 patients, weakness of fine movements in 4 patients, sphincteric manifestation in 2 patients, cerebellar dysfunction in 2 patients. The clinical outcome was assessed as: 1. Good: patients having marked improvement with no residual symptoms causing any sort of disability. 2. Fair: patients having residual symptoms causing mild disability in performing their usual daily activities. 3. Poor: patients having no improvement at all.This assessment from E.J.N.S.vol.24 no.2 june 2009.In our study, 6 patients reported good out come,2 fair,2 poor



Chiari malformation type 1 Hydrocephalus Posterior fossa decompression