title: Comparison of clinical and radiological manifestations and surgical outcomes of pediatric Chiari I malformations in different age groups.
abstract: OBJECTIVE
  The aim of this study was to elucidate the differences in clinical and radiological manifestations and treatment outcomes of pediatric Chiari I malformation patients according to age.
  
  
  METHODS
  We retrospectively reviewed the patients who received surgery in our institution for symptomatic Chiari I malformations between January 1991 and December 2012. Fifty-four patients were identified, and their medical records were reviewed for clinical presentation, radiological findings, surgical treatment, and outcomes including complications. We divided the patients into 3 groups: Group I (n = 4) younger than 3 years old; Group II (n = 9) between 3 and 5 years old; and Group III (n = 41) older than 5 years old. Surveyed data were compared among the groups. The mean follow-up period was 82.8 months.
  
  
  RESULTS
  All of Group I patients presented with stem compression signs. Ventriculomegaly was common (3/4, 75%), but no syrinx or scoliosis was observed. In Group II, scoliosis was the most common presentation (5/9, 56%), and these patients rarely complained any other symptoms. Pain, such as headache (18/41, 44%), was the predominant presentation in Group III. The incidences of syrinx and scoliosis were similar in Groups II and III. There were no differences in the treatment outcomes among the groups. The spinal curve did not improve in 4 of 5 Group II patients despite their early FMD surgeries. The incidence of complications related to cerebrospinal fluid leakage was higher in the young age group.
  
  
  CONCLUSIONS
  The clinical and radiological manifestations of pediatric Chiari I malformation appeared to be different according to age.
authors.affiliation: Department of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, Republic of Korea.|Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sungjoon
authors.initials: S
authors.lastname: Lee
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Yeoun
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Phi
authors.affiliation: Division of Pediatric Radiology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Cheon
authors.affiliation: Division of Pediatric Radiology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: In One
authors.initials: IO
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, the Armed Forces Capital Hospital, Seongnam, Republic of Korea.
authors.forename: Byung-Kyu
authors.initials: BK
authors.lastname: Cho
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. kcwang@snu.ac.kr.
authors.forename: Kyu-Chang
authors.initials: KC
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000375:Aging; D001139:Arnold-Chiari Malformation / Q000000981:diagnostic imaging* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Cerebrospinal fluid; Chiari I malformation; Pathophysiology; Pediatric; Surgical outcome; Young age