[Cerebellar amygdalopexy in the management of Chiari I malformation].
BACKGROUND
The treatment of Chiari I malformation associated with syringomyelia is controversial.


OBJECTIVE
We describe a series of patients with this disease treated during a twelve-year period. We also present clinical, surgical and radiological findings.


METHODS
Forty eight patients were included; a non significant female predominance was found. Clinical course was characterized by headache, cerebellar signs and symptoms, neck pain and involvement of lower cranial nerves and pyramidal tract. The degree of tonsillar descent and syringomyelia size varied and a correlation between them was not found. Surgery consisted in an occipital craniectomy, C1 laminectomy and tonsillar elevation through bipolar coagulation and duraplasty.


RESULTS
The best results were observed in pain and cerebellar symptoms, while a deficit of lower cranial nerves and pyramidal tract were observed. However, in most patients we were able to slow symptom progression. No adverse effects were documented.


CONCLUSIONS
The surgicalprocedureproposed herein is an effective and safe treatment alternative for this malformation, and its results are comparable to other riskier procedures.
Guinto-Balanzar
Gerardo
G
Servicios de Neurocirugía, Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México. gguinto@prodigy.net.mx
Zamorano-Bórquez
Carlos
C
Domínguez-Cortinas
Félix
F
Aréchiga-Ramos
Norma Claudia
NC
Abdo-Toro
Miguel Adolfo
MA
D000328:Adult; D000679:Amygdala / Q000601:surgery*; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D004388:Dura Mater / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013595:Syringomyelia / Q000150:complications; D016896:Treatment Outcome