Are Herniated Cerebellar Tonsils the Main Culprit of Chiari Malformation Type I Symptoms? The Brainstem Compression Hypothesis seems to be Re-Elucidated and Revised.
OBJECTIVE
The Chiari Malformation I (CM I) and the tethered cord syndrome (TCS) are both congenital abnormalities whose mechanisms are still not fully understood. The association of CM I and TCS has been reported only a few times previously.


METHODS
This retrospective study included 7 patients who were diagnosed with CM I and TCS, managed by cutting of the filum terminale.


RESULTS
The mean follow-up period was 21 months and 28 days. Although all patients underwent an untethering surgical procedure by cutting the filum terminale only, all patients reported significant early postsurgical resolution of CM I symptoms and symptoms related to TCS as well.


CONCLUSIONS
Patients with symptomatic CM I, even if lumbar MRI is normal and the patient asymptomatic for TCS, may have tethered spinal cord at the same time. It seems it would be worthwhile to investigate CM I patients for occult TCS with spinal somatosensory evoked potentials.
Celal Bayar University, School of Medicine, Department of Neurosurgery, Manisa, Turkey.
Mehmet
M
Selcuki
Mesut
M
Mete
Deniz
D
Selcuki
D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D001933:Brain Stem / Q000000981:diagnostic imaging* / Q000601:surgery; D004677:Encephalocele / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009436:Neural Tube Defects / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult