AI Article Synopsis

  • - A 20-year-old woman with Chiari malformation and syringomyelia underwent two surgeries, starting with a decompression and laminectomy at age 9, but continued to experience symptoms like gait disturbance and sweating.
  • - The initial surgery didn’t fully alleviate her symptoms, and a second procedure was needed due to recurrent stenosis, potentially linked to inadequate decompression and the growth of new bone.
  • - Post second surgery, some symptoms improved, highlighting the importance of ongoing monitoring after surgery for Chiari malformation, especially in young patients.

Article Abstract

We present the case of a 20-year-old female who underwent foramen magnum decompression and laminectomy of C1-C3 as well as incision of only the outer layer of the dura, for her symptomatic Chiari malformation (type 1) with syringomyelia, at the age of 9 years. She required additional surgery with removal of regenerated bone and dural plasty for the remaining and recurrent stenosis. The remaining stenosis may have been caused by the use of a technique without dural plasty and insufficient decompression of the bony structure. Further, the regeneration of C1 lamina could have been responsible for the recurrent stenosis. Her symptoms, which included gait disturbance, hypesthesia, excessive sweating, and nocturnal enuresis, manifested themselves when she was at the age of 2 years and progressed since that time. These symptoms didn't improve after the first surgery. However, after the second surgery, the gait disturbance and nocturnal enuresis were partially resolved. It is rare for new bone generation to necessitate reoperation. However, it should be noticed that careful follow-up is important after decompressive surgery for Chiari malformation in young patients.

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