title: Natural history of Chiari type I malformation in children.
abstract: The decision on whether or not to operate children with Chiari type I malformation (CIM) is difficult and controversial, because of the lack of information about the natural evolution of such a disease. Herein, we report on the evolution of 16 asymptomatic children with incidentally diagnosed CIM (mean age: 6.7 years; mean follow-up: 5.8 years). No patients required suboccipital decompression. Thirteen children remained asymptomatic, with stable or improved radiological picture (worsening in 2 cases). Three cases showed appearance of symptoms: one did not require any treatment; the remaining two underwent endoscopic third ventriculostomy because of hydrocephalus, which is a possible consequence of CIM. This analysis shows a favorable natural outcome of CIM in children, thus suggesting a conservative management in asymptomatic cases. However, multicentric studies are required to validate this data.
authors: Department of Neurosciences, Pediatric Neurosurgery, A. Gemelli Hospital, Rome, Italy. lmassimi@email.it
authors: Luca
authors: L
authors: Massimi
authors: Massimo
authors: M
authors: Caldarelli
authors: Paolo
authors: P
authors: Frassanito
authors: Concezio
authors: C
authors: Di Rocco
mesh_terms: D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies