Suboccipital craniectomy with opening of the fourth ventricle and duraplasty: study of 192 cases of craniovertebral malformations

Author:

Silva Jose Alberto Goncalves da1,Santos Jr. Adailton Arcanjo dos2,Costa Maria do Desterro Leiros da3,Almeida Everardo Bandeira de4

Affiliation:

1. Hospital Unimed, Brazil

2. Hospital Beneficencia Portuguesa de Sao Paulo, Brazil

3. Federal University of Paraiba, Brazil

4. Neuro-anesthesist, João Pessoa PB, Brazil.

Abstract

The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM), and/or syringomyelia (SM) is based on restoration of the normal cerebrospinal fluid (CSF) dynamics at the craniovertebral junction and creation of a large artificial cisterna magna, avoiding the caudal migration of the hindbrain. It is observed that a large craniectomy might facilitate an upward migration of the posterior fossa structures. There are many surgical techniques to decompress the posterior fossa; however, a gold standard approach remains unclear. The authors present the results of 192 cases of BI, CM, and SM treated between 1975 and 2008 and whose surgical treatment was characterized by a large craniectomy without tonsillectomy with the patient in the sitting position, large opening of the fourth ventricle, and duraplasty.

Publisher

FapUNIFESP (SciELO)

Subject

Neurology,Clinical Neurology

Reference29 articles.

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2. Beiträge zur Pathologie und pathologischen Anatomie des Central-Nervensystem;Simon Th;Arch Psychiat Nervenkr,1875

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