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Anesthetic Management of a Patient With Arnold Chiari Malformation and Syringomyelia During Laparoscopic Surgery With Neurologic Monitoring: A Case Report.
A A Pract
January 2025
Département d'Anesthésie, Hôpital Antoine Béclère, APHP.Université Paris-Saclay, Clamart, France.
We describe a patient with severe Arnold Chiari Malformation and syringomyelia who underwent gynecological laparoscopy in an emergency context; no brain imaging was available. We here report the successful use of optic nerve sheath diameter (ONSD) and middle cerebral artery (MCA) velocity measurements as surrogate monitoring for cerebral blood flow and intracranial pressure, respectively. MCA velocity was low when assessed after peritoneal insufflation and ONSD increased to 6.
View Article and Find Full Text PDFChiari Malformation Type I and Syringomyelia: Outcomes of Arachnoid-Preserving Surgical Technique.
Med Sci Monit
January 2025
Department of Neurosurgery, Istanbul Training and Research Hospital, Istanbul, Turkey.
BACKGROUND Chiari malformation type 1 occurs when the cerebellar tonsils are pushed into the spinal canal, which can result in syringomyelia. This retrospective study from a single center evaluated outcomes in 89 patients with Chiari malformation type-I (CM-I) and syringomyelia treated with an arachnoid-preserving technique between 2016 and 2023. MATERIAL AND METHODS A retrospective analysis was conducted at a tertiary referral center, involving 88 adult patients and 1 adolescent patient aged 14 to 61 years, with diagnosis by MRI and treated for CM-I with syringomyelia between 2016 and 2023, using the arachnoid-preserving technique.
View Article and Find Full Text PDFLeptomeningeal Masses or Masquerades: A Spectrum of Diseases with Leptomeningeal Enhancement and their Mimics.
Curr Med Imaging
January 2025
Department of Radiology, Sengkang General Hospital, Singapore.
Background: Leptomeningeal enhancement, visible on MRI, can indicate a variety of diseases, both neoplastic and non-neoplastic.
Objective: This comprehensive pictorial review aims to equip radiologists and trainees with a thorough understanding of the diverse imaging presentations of leptomeningeal disease.
Methods: Drawing from a retrospective analysis of MRI scans conducted between 1 January 2008 and 30 September 2022, at two tertiary teaching hospitals in Singapore, this review covers a wide range of conditions.
Visual impairment associated with direct compression of the visual cortex due to subdural hematoma following foramen magnum decompression: illustrative case.
J Neurosurg Case Lessons
December 2024
Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan.
Background: Postoperative subdural hematoma (SDH) typically presents with headache, impaired consciousness, hemiplegia, gait disturbance, and aphasia but can also present with visual impairment.
Observations: A 52-year-old woman diagnosed with Chiari malformation type I and syringomyelia underwent foramen magnum decompression. Cerebrospinal fluid was lost due to arachnoid injury during the procedure.
Impacts of type 1 Chiari malformation on elderly.
Surg Neurol Int
November 2024
Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
Background: This study aims to evaluate the surgical outcomes of elderly patients with Chiari malformation (CM) who underwent suboccipital craniectomy (SC) with duraplasty (DP) or dural splitting (DS). The focus is on symptom relief, changes in syrinx size, hospital admission duration, and postoperative complications.
Methods: A retrospective study was performed to evaluate the outcomes of elderly CM patients who underwent SC with DP or dural splitting (DS).
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