Felipe Hada Sanders1, Joy M H Wang2, Rod J Oskouian3, R Shane Tubbs3, W Jerry Oakes4. 1. Neurosurgery Division, Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 2. Department of Anatomical Sciences, St. George's University, St. George's, West Indies, Grenada. MWANG@SGU.EDU. 3. Seattle Science Foundation, Seattle, WA, USA. 4. Children's of Alabama, Birmingham, AL, USA.
Abstract
INTRODUCTION: The Chiari I malformation (CIM) is commonly encountered by neurosurgeons and can have different etiologies and clinical presentations. CASE REPORT: We report a CIM patient who presented with symptoms of ventral brain stem compression and was found to have a large peri-odontoid pannus. Posterior fossa decompression was performed with a planned second-stage odontoidectomy. However, at the 6-month follow-up, postoperative images demonstrated a mostly resolved pannus and improvement of the brain stem compression symptoms, and the patient progressed uneventfully without the need for odontoidectomy. CONCLUSIONS: This case illustrates the resolution of a significant and symptomatic peri-odontoid pannus in a patient with CIM without craniocervical fusion or odontoidectomy. Such a case indicates that not all peri-odontoid pannus formations in CIM patients are due to hypermobility at the craniocervical junction.
INTRODUCTION: The Chiari I malformation (CIM) is commonly encountered by neurosurgeons and can have different etiologies and clinical presentations. CASE REPORT: We report a CIM patient who presented with symptoms of ventral brain stem compression and was found to have a large peri-odontoid pannus. Posterior fossa decompression was performed with a planned second-stage odontoidectomy. However, at the 6-month follow-up, postoperative images demonstrated a mostly resolved pannus and improvement of the brain stem compression symptoms, and the patient progressed uneventfully without the need for odontoidectomy. CONCLUSIONS: This case illustrates the resolution of a significant and symptomatic peri-odontoid pannus in a patient with CIM without craniocervical fusion or odontoidectomy. Such a case indicates that not all peri-odontoid pannus formations in CIM patients are due to hypermobility at the craniocervical junction.
Authors: R Shane Tubbs; Christoph J Griessenauer; Philipp Hendrix; Peter Oakes; Marios Loukas; Joshua J Chern; Curtis J Rozzelle; W Jerry Oakes Journal: Clin Anat Date: 2015-05-14 Impact factor: 2.414
Authors: Alfonso Lagares; Iñaki Arrese; Beatriz Pascual; Pedro A Gòmez; Ana Ramos; Ramiro D Lobato Journal: Eur Spine J Date: 2005-12-29 Impact factor: 3.134