Joshua Pepper1, Ahmed Elhabal2, Georgios Tsermoulas2, Graham Flint2. 1. Department of Neurosurgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, B29 4AB, UK. joshua.pepper1@nhs.net. 2. Department of Neurosurgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, B29 4AB, UK.
Abstract
BACKGROUND: Specific symptom outcomes after craniovertebral decompression for patients with Chiari type 1 malformation, without accompanying syringomyelia, are not well characterised and poorly reported. METHODS: We performed a retrospective review of all patients diagnosed with Chiari type 1, without syringomyelia, who underwent craniovertebral decompression in our unit. RESULTS: We identified 129 individuals with a minimum of 2 years' follow-up. The most common pre-operative symptoms were pressure dissociation headaches (78%), visual disturbances (33%), dizziness/balance disturbances (24%) and blackouts (17%). The symptoms most likely to respond to surgery included Valsalva-induced headache (74% response, p < 0.0001) and blackouts (86% response, p < 0.001). CONCLUSIONS: After successful craniovertebral decompression, most patients presenting with pressure dissociation headaches and blackouts will improve. However, the large variety of other symptoms patients often present with may not improve after surgery.
BACKGROUND: Specific symptom outcomes after craniovertebral decompression for patients with Chiari type 1 malformation, without accompanying syringomyelia, are not well characterised and poorly reported. METHODS: We performed a retrospective review of all patients diagnosed with Chiari type 1, without syringomyelia, who underwent craniovertebral decompression in our unit. RESULTS: We identified 129 individuals with a minimum of 2 years' follow-up. The most common pre-operative symptoms were pressure dissociation headaches (78%), visual disturbances (33%), dizziness/balance disturbances (24%) and blackouts (17%). The symptoms most likely to respond to surgery included Valsalva-induced headache (74% response, p < 0.0001) and blackouts (86% response, p < 0.001). CONCLUSIONS: After successful craniovertebral decompression, most patients presenting with pressure dissociation headaches and blackouts will improve. However, the large variety of other symptoms patients often present with may not improve after surgery.
Entities:
Keywords:
Chiari I; Craniovertebral decompression; Foramen magnum decompression; Symptom outcome
Authors: Maria F Dien Esquivel; Neetika Gupta; Nagwa Wilson; Christian Alfred O'Brien; Maria Gladkikh; Nick Barrowman; Vid Bijelić; Albert Tu Journal: Childs Nerv Syst Date: 2022-08-12 Impact factor: 1.532