Delayed resolution of Chiari I-associated hydromyelia after posterior fossa decompression: case report and review of the literature

Neurosurgery. 2004 Sep;55(3):711. doi: 10.1227/01.neu.0000134548.16165.9.

Abstract

Objective and importance: The expected time interval for resolution of hydromyelia after Chiari I decompression is lacking in the literature. This case report highlights one instance of delayed resolution of Chiari-induced hydromyelia.

Clinical presentation: We report an adolescent girl with a Chiari I malformation and hydromyelia.

Intervention: A suboccipital craniectomy and C1 laminectomy with intradural exploration and duraplasty were performed. Serial imaging at 1 and 2 years after posterior cranial fossa decompression with duraplasty demonstrated no change in the size of the hydromyelia. At 3 years after surgery and before reoperation for continued hydromyelia, repeat magnetic resonance imaging demonstrated significant diminution of the fluid cavity. If this hydromyelia did resolve as a result of surgery, the interval for radiological observation clearly needs to be reconsidered.

Conclusion: Unfortunately, this is an area in which the literature is lacking. With this case as a nidus, studies are now necessary to determine the range of time necessary for Chiari I malformation-related hydromyelia to resolve.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Arnold-Chiari Malformation / complications*
  • Cranial Fossa, Posterior / pathology
  • Cranial Fossa, Posterior / surgery*
  • Craniotomy
  • Decompression, Surgical*
  • Female
  • Humans
  • Laminectomy
  • Magnetic Resonance Imaging
  • Reoperation
  • Syringomyelia / diagnosis
  • Syringomyelia / etiology*
  • Syringomyelia / surgery*
  • Time Factors
  • Treatment Outcome