title: [Cisterno-medullary anomalies. Diagnostic problems, surgical treatment (author's transl)].
abstract: Under the term cisterno-medullary anomalies are included several disorders: bony and nervous malformations, arachnoiditis of the posterior fossa. As they are frequently associated, a thorough investigation, both anatomical and dynamic, is a prerequisite to any therapeutic attempt. Along with causing damage to the neuraxis, these anomalies interfere with the dynamics of the CSF and may lead to the development of a communicating syringomyelia, whatever the theory proposed. The presenting symptoms are varied, and diagnosis should be accordingly suspected. Of fundamental importance are instrumental investigations. A complete evaluation is in most of the cases obtainable with: bone X-rays, air-myelography (or "bulle"), intrathecal ou ventricular radio-isotope scan. Surgery is the only treatment. The aim is both decompression of the neural structures and restoration of a normal CSF dynamic flow. Opening of the posterior fossa is successful in the case of developmental abnormalities, But it seems to prove a failure when the chief anomaly is arachnoiditis. In such cases, ventricular drainage alone may be followed by improvement. It appears from this that the problem is twofold: the technical problem of the drainage, and the pre-operatory diagnosis of a posterior fossa arachnoiditis.
mesh_terms: D000293:Adolescent; D000328:Adult; D001100:Arachnoiditis / Q000175:diagnosis; D002490:Central Nervous System / Q000000981:diagnostic imaging; D002493:Central Nervous System Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D014695:Cerebral Ventriculography; D002574:Cervical Vertebrae / Q000473:pathology; D002946:Cisterna Magna / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009192:Myelography; D011877:Radionuclide Imaging; D014711:Vertebral Artery / Q000000981:diagnostic imaging
vernacular_title: Les anomalies de la région bulbo-cisternale. Leurs problèmes diagnostiques, leur traitement chirurgical.