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Multicenter comparison of Chiari malformation type I presentation in children versus adults.
Mortazavi, Armin; Almeida, Neil D; Hofmann, Katherine; Davidson, Laurence; Rotter, Juliana; Phan, Tiffany N; Tsering, Deki; Maxwell, Christina; Karunakaran, Jehshua; Veznedaroglu, Erol; Caputy, Anthony J; Heiss, John D; Sandhu, Faheem A; Myseros, John S; Oluigbo, Chima; Magge, Suresh N; Shields, Donald C; Rosner, Michael K; Chatain, Grégoire P; Keating, Robert F.
Afiliación
  • Mortazavi A; 1Georgetown University School of Medicine, Washington, DC.
  • Almeida ND; 2George Washington University School of Medicine and Health Sciences, Washington, DC.
  • Hofmann K; 3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
  • Davidson L; 3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
  • Rotter J; 4Division of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland.
  • Phan TN; 1Georgetown University School of Medicine, Washington, DC.
  • Tsering D; 3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
  • Maxwell C; 3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
  • Karunakaran J; 5Global Neurosciences Institute, Philadelphia, Pennsylvania.
  • Veznedaroglu E; 2George Washington University School of Medicine and Health Sciences, Washington, DC.
  • Caputy AJ; 5Global Neurosciences Institute, Philadelphia, Pennsylvania.
  • Heiss JD; 2George Washington University School of Medicine and Health Sciences, Washington, DC.
  • Sandhu FA; 6Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
  • Myseros JS; 7Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC; and.
  • Oluigbo C; 3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
  • Magge SN; 3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
  • Shields DC; 3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
  • Rosner MK; 2George Washington University School of Medicine and Health Sciences, Washington, DC.
  • Chatain GP; 2George Washington University School of Medicine and Health Sciences, Washington, DC.
  • Keating RF; 8Department of Neurosurgery, University of Colorado, Aurora, Colorado.
J Neurosurg Pediatr ; 34(1): 49-56, 2024 Jul 01.
Article en En | MEDLINE | ID: mdl-38394661
ABSTRACT

OBJECTIVE:

Treatment for Chiari malformation type I (CM-I) often includes surgical intervention in both pediatric and adult patients. The authors sought to investigate fundamental differences between these populations by analyzing data from pediatric and adult patients who required CM-I decompression.

METHODS:

To better understand the presentation and surgical outcomes of both groups of patients, retrospective data from 170 adults and 153 pediatric patients (2000-2019) at six institutions were analyzed.

RESULTS:

The adult CM-I patient population requiring surgical intervention had a greater proportion of female patients than the pediatric population (p < 0.0001). Radiographic findings at initial clinical presentation showed a significantly greater incidence of syringomyelia (p < 0.0001) and scoliosis (p < 0.0001) in pediatric patients compared with adult patients with CM-I. However, presenting signs and symptoms such as headaches (p < 0.0001), ocular findings (p = 0.0147), and bulbar symptoms (p = 0.0057) were more common in the adult group. After suboccipital decompression procedures, 94.4% of pediatric patients reported symptomatic relief compared with 75% of adults with CM-I (p < 0.0001).

CONCLUSIONS:

Here, the authors present the first retrospective evaluation comparing adult and pediatric patients who underwent CM-I decompression. Their analysis reveals that pediatric and adult patients significantly differ in terms of demographics, radiographic findings, presentation of symptoms, surgical indications, and outcomes. These findings may indicate different clinical conditions or a distinct progression of the natural history of this complex disease process within each population, which will require prospective studies to better elucidate.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Malformación de Arnold-Chiari / Descompresión Quirúrgica Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurosurg Pediatr Asunto de la revista: NEUROCIRURGIA / PEDIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Malformación de Arnold-Chiari / Descompresión Quirúrgica Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurosurg Pediatr Asunto de la revista: NEUROCIRURGIA / PEDIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos