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Child's Nervous System

Erschienen in:

27.06.2023 | Original Article

Chiari I malformation: management evolution and technical innovation

verfasst von: Federico Bianchi, Benedetta Montedoro, Paolo Frassanito, Luca Massimi, Gianpiero Tamburrini

Erschienen in: Child's Nervous System | Ausgabe 10/2023

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Abstract

Background and definition

In recent years thanks to the growing use of radiological assessment, Chiari I malformation became one of the major diseases for a neurosurgeon to deal with. CIM can be classified according to the extent of cerebellar tonsil tip into the foramen magnum being a protrusion over five mm considered pathological. Such a disease is a heterogeneous condition with a multifactorial pathogenetic mechanism that can subdivided into a primary and secondary form. Regardless of the form, it seems that CIM is the result of an imbalance between the volume of the braincase and its content. Acquired CIMs are secondary to conditions causing intracranial hypertension or hypotension while the pathogenesis of primary forms is still controversial.

Pathogenesis and treatment

There are several theories in the literature but the most accepted one implies an overcrowding due to a small posterior cranial fossa. While asymptomatic CIM do not need treatment, symptomatic ones prompt for surgical management. Several techniques are proposed being the dilemma centered in the need for dural opening procedures and bony decompression ones.

Conclusion

Alongside the paper, the authors will address the novelty presented in the literature on management, diagnosis and pathogenesis in order to offer a better understanding of such a heterogeneous pathology.

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Titel: Chiari I malformation: management evolution and technical innovation
verfasst von: Federico Bianchi
Benedetta Montedoro
Paolo Frassanito
Luca Massimi
Gianpiero Tamburrini
Publikationsdatum: 27.06.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Child's Nervous System / Ausgabe 10/2023
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-023-06051-7

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