摘要
Abstract
Objective To observe and analyze the change of the clinical manifestation and MRI of Chiari I malformation after the treatment of foramen magnum decompression combined with removal of the outer layer of the dura, and to evaluate the correlation between the therapeutic outcome and the treatment. Methods The patients with Chiari I malformation diagnosed according to their clinical manifestations and MRI were treated with foramen magnum decompression with removal of the outer layer of the dura, and were followed up by our neurological center. Clinical and MRI data were researched of 45 patients diagnosed with Chiari I malformation, and then the patients were divided into two groups: group I of Chiari I malformation without syringomyeha (n - 17), and group II of Chiari I malformation with syringomyelia (n = 28). Further,clinical and MRI changes pre and post operation were compared. Results Main clinical symptoms of the 17 patients were obviously improved after the surgery, no obvious MRI changes after operation were found except for elevated tonsil of cerehellum and deepened cisterna magna, and no syringomyelia was developed. The other 28 patients with syringomyelia, whose clinical symptoms included limb numbness and anesthesia,also gained ideal improvement. Their syringomyelia was alleviated,and even disappeared during the follow-up, .meanwhile, discomforts like numbness,pain and sensation loss were relieved. However,symptoms such as myatrophy and sphincter disfunction were found no obvious change. Conclusion Foramen magnum decompression with removal of the outer layer of the dura for treatment of Chiari I malformation is effective. Chiari I malformation patients without syringomyelia can get greater improvement,and early operational treatment may reduce the incidence rate of syringomyelia in them.关键词
Chiari畸形Ⅰ型/脊髓空洞/枕骨大孔减压Key words
Chiari I malformation/syringomyelia/foramen magnum decompression分类
医药卫生
