Posterior fossa decompression with tonsillectomy in 104 cases of basilar impression, Chiari malformation and/or syringomyelia

José Alberto Gonçalves da Silva, Adailton Arcanjo dos Santos Jr, Luiz Ricardo Santiago Melo, Antônio Fernandes de Araújo, Giseuda Pessoa Regueira
2011 Arquivos de Neuro-Psiquiatria  
The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM) and/or syringomyelia (SM) is based on the restoration of the normal cerebrospinal fluid (CSF) dynamics at the craniovertebral junction through the creation of a large artificial cisterna magna. A small suboccipital craniectomy has been emphasized to avoid caudal migration of the hindbrain structures into the vertebral canal. Nevertheless, the results showed downward migration of the hindbrain
more » ... the hindbrain related to that type of craniectomy. The authors present, otherwise, the results of 104 cases of BI, CM and/or SM, whose surgical treatment was characterized by a large craniectomy with the patient in the sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large artificial cisterna magna. A significant upward migration of the posterior fossa structures was detected by postoperative magnetic resonance imaging.
doi:10.1590/s0004-282x2011000600018 pmid:22042188 fatcat:lqu3u2g65zhixnzfylqvequrby