Results of surgical treatment of syringomyelia associated with Chiari 1 malformation. An analysis of 125 cases

Зуев, А. А.; Pedyash, N V; Epifanov, D. S.; Костенко, Глеб Владимирович

doi:10.17116/neiro201680127-34

Cited by 15 publications

(7 citation statements)

References 16 publications

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“…Syringomyelia (SM) is a rare, progressive disease of the spinal cord and it presents with mild to severe neurological complaints, with the characteristic intramedullary cyst,1 occurring mostly from underlying causes such as Chiari malformations (CMs) 1. CM incidence is approximately 3–8/100,000, with 62% to 80% exhibiting SM,2 and it shows a predilection to certain geographic locations such as Russia 34. Over 50% of the cases are because of Arnold-Chiari malformation type 1, characterized by herniation of cerebellar tonsils through the foramen magnum, followed by trauma-related incidence (25% of cases), the other types being rarer 15.…”

Section: Introductionmentioning

confidence: 99%

“…When the symptoms are severe, surgery/shunting/cordectomy/cellular neuro-construction may be offered to the patient, depending on the underlying cause 1. Stabilization of the neurological symptoms and improvement in the general condition are the aims of treatment 2. Surgery is effective in most cases, but over 50% of patients require re-operation at some point 1.…”

Section: Introductionmentioning

confidence: 99%

“… 1 CM incidence is approximately 3–8/100,000, with 62% to 80% exhibiting SM, 2 and it shows a predilection to certain geographic locations such as Russia. 3 4 Over 50% of the cases are because of Arnold-Chiari malformation type 1, characterized by herniation of cerebellar tonsils through the foramen magnum, followed by trauma-related incidence (25% of cases), the other types being rarer. 1 5 Many theories were proposed to explain the dynamics behind the development of SM, including the three popular theories of Gardner, Williams, and Oldfield.…”

Section: Introductionmentioning

confidence: 99%

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Syringomyelia Managed with Classical Homeopathy: A Case Report

Rudakova¹,

Mahesh

Vithoulkas

2021

Annals of Neurosciences

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Background: Syringomyelia (SM) with Chiari malformation is a rare disease with an unpredictable course. Surgery and other interventions help reduce the severity of symptoms, but over 50% patients require re-operation. Auto-resolution is rare in this type of SM, and most cases progress to complications, which may amount to a great burden. Case presentation: We present a case of SM with Arnold-Chiari malformation type 1 in a 54-year-old Russian woman who was treated with individualized classical homeopathy for over eight years with remarkable improvement in the clinical signs and symptoms of the condition and comorbidities. On MRI, the syrinx completely resolved, which further confirmed the benefit of this therapy. Conclusion: This case of SM with Arnold-Chiari malformation type 1 seemed to benefit from individualized classical homeopathy. Scientific investigation into an individualized classical homeopathic approach towards SM is necessary to establish its relevance in this condition.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Syringomyelia Managed with Classical Homeopathy: A Case Report

Rudakova¹,

Mahesh

Vithoulkas

2021

Annals of Neurosciences

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“…Основанием для ликворошунтирующего вмеша-тельства послужили резистентность симптомов си-рингомиелии к консервативному лечению и неэф-фективность предшествующего оперативного лече-ния, направленного на основное ассоциированное состояние, коррекция которого, согласно опыту ря-да авторов, в большинстве случаев приводит к по-следующему регрессу сирингомиелии [1,38,39].…”

Section: клинический случайunclassified

Syringosubarachnoid shunting in treatment of syringomyelia: a literature review and a clinical case report

et al. 2017

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1 ФГБУ «Федеральный центр нейрохирургии» Минздрава России, Новосибирск, Россия; 2 ГБОУ ВО «Московский государственный медицинский университет им. А.И. Евдокимова» Минздрава России, Москва, Россия Описан клинический случай сирингомиелии, ассоциированной с аномалией Арнольда-Киари 1-го типа, проведена оценка эффективности метода сирингосубарахноидального шунтирования, а также проанализированы данные литера-туры отечественных и зарубежных авторов, занимающихся изучением и лечением данной патологии. Результатом применения метода сирингосубарахноидального шунтирования в описываемом случае явился регресс пареза и гипестезии, что продемонстрировало эффективность шунтирующей методики для коррекции симптомов сирингомие-лии. Список сокращений DREZ (dorsal root entry zone) -зона входа чувствительных корешков ВКЖ -внеклеточная жидкость ЗЧЯ -задняя черепная ямка МРТ -магнитно-резонансная томография НФТО -нарушение функций тазовых органов ПСМТ -позвоночно-спинномозговая травма ПТСМ -посттравматическая сирингомиелия САК -субарахноидальное кровоизлияние САП -субарахноидальное пространство СМЖ -спинномозговая жидкость ТМО -твердая мозговая оболочка ЦНС -центральная нервная система ЦСЖ -цереброспинальная жидкость ЭОП -электронно-оптический преобразователь Сирингомиелия -хроническое заболевание спинного мозга, характеризующееся интрамедул-лярным кистообразованием. Чаще всего это не само-стоятельная нозология, а позднее осложнение ос-новного заболевания [1].Впервые сирингомиелитические полости в спинном мозге были описаны A. Portal [2] как ау-топсийная находка. Как правило, такая полость со-держит прозрачную жидкость, которая неотличима от ликвора или внеклеточной жидкости, а стенки

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“…Removal of the outer layer of the dura mater (also termed the 'dural band') or duraplasty has been reported as an adjunctive decompression technique for human patients with CM-I. Additionally, there have been several studies describing boney decompression alone versus boney decompression with duraplasty [22,[27][28][29][30][31][32][33][34]. Boney decompression with duraplasty has been associated with a signi cant reduction in the volume of syrinxes with subsequent improvement of neurologic clinical signs in the human patient [32].…”

Section: Introductionmentioning

confidence: 99%

Histologic findings of the dura mater at the level of the foramen magnum in 121 CKCS with Chiari-like malformation

Holdsworth

Marino

Loughin

et al. 2021

Preprint

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Background: To describe histopathologic features found in dural biopsies of Cavalier King Charles Spaniels (CKCS) with Chiari-like malformation (CM) and identify any associations between age, duration of clinical signs, syrinx location or syringomyelia (SM) and quality of life (QOL). The medical records of 121 consecutive client owned CKCS with CM and SM, confirmed by whole body magnetic resonance imaging (MRI), that underwent foramen magnum decompression (FMD) with cranioplasty and durectomy with biopsy from 2006 to 2016 were retrospectively reviewed. Dura biopsies were submitted to a board-certified veterinary pathologist for histopathologic interpretation. The chi-square test was used to analyze associations between diagnosis and categorical variables. For continuous measures, the Kruskal-Wallis non-parametric test was used to compare distributions across pathology categories. A result was considered statistically significant at the P<0.05 level of significance. Results: The mean age, duration of pre-surgical clinical signs, and pre-operative QOL (1-5 scale) were 44.27 months, 44.78 weeks, and 2.72 respectively. Syringomyelia was found in the cervical region only in thirty-nice of one hundred twenty-one (32.23%) of dogs, in the cervical and thoracic region only in seventeen of one hundred twenty-one (14.05%) of dogs, and in the cervical, thoracic and lumbar region combined in sixty-five of one hundred twenty-one (53.72%) of dogs. Sixty-six of one hundred twenty-one (54.55%) dural biopsy specimens had histopathology changes; fifty-five (45.45%) did not. Forty-three of one hundred twenty-one (35.54%) dural biopsy specimens had osseous metaplasia, sixteen of one hundred twenty-one (13.22%) had evidence of fibrosis, four of one hundred twenty-one (3.31%) had arachnoid hyperplasia, and three of one hundred twenty-one (2.48%) had evidence of mineralization. Conclusions: The majority of dogs with CM were found to have histopathologic changes in the dura at the time of FMD cranioplasty was performed. These dural changes can be observed in dogs experiencing clinical signs for a time period as short as four weeks prior to presentation. Histopathologic changes were not associated with age, breed, duration of clinical signs, the location of syringomyelia or preoperative QOL. The influence of histopathologic changes on long term prognosis in dogs without dural decompression is unknown since all dogs in this study had dural resection.

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Results of surgical treatment of syringomyelia associated with Chiari 1 malformation. An analysis of 125 cases

Cited by 15 publications

References 16 publications

Syringomyelia Managed with Classical Homeopathy: A Case Report

Syringomyelia Managed with Classical Homeopathy: A Case Report

Syringosubarachnoid shunting in treatment of syringomyelia: a literature review and a clinical case report

Histologic findings of the dura mater at the level of the foramen magnum in 121 CKCS with Chiari-like malformation

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