Sequential morphological change of Chiari malformation type II following surgical repair of myelomeningocele

Kimiaki Hashiguchi, Takato Morioka, Nobuya Murakami, Osamu Togao, Akio Hiwatashi, Masayuki Ochiai, Goki Eriguchi, Junji Kishimoto, Koji Iihara

研究成果: Contribution to journalArticle査読

5 被引用数 (Scopus)

抄録

Purpose: To document long-term morphological changes of Chiari type II malformation (CM-II) following closure of spina bifida manifesta (SBM). Methods: We retrospectively evaluated postnatal magnetic resonance images of the CM-II and posterior fossa (PF) in 28 consecutive cases. We measured changes in vertebral level and length of the cerebellar peg (CP), cerebrospinal fluid (CSF) spaces anterior and posterior to the cerebrospinal junction, PF area, and the anteroposterior diameters of the foramen magnum (FM) and C1 vertebra. We examined the morphological differences between the cases with and without ventriculoperitoneal (VP) shunting and derived predicted means by nonlinear mixed-effect modeling. Results: At birth, there were significant differences in CP length, PF area, and FM and C1 diameters between those who underwent VP shunting and those who did not. In cases with a CP below C1, VP shunting was required in every case but one. In those with visible CSF space at birth, VP shunts were not required. In 17 of 18 cases with a CP below C1, the vertebral level ascended by mean two vertebral levels (range 0–5 levels) within 4–6 months of delivery. In the remaining case, slowly progressive hydrocephalus and delayed CP descent required VP shunting at 8 months. Predicted mean CP length and FM and C1 diameters were greater in those who underwent VP shunting, but there was no difference in predicted mean PF area. Conclusion: The morphology of CM-II and the presence of hydrocephalus influence each other in children who have undergone postnatal SBM repair.

本文言語英語
ページ(範囲)1069-1078
ページ数10
ジャーナルChild's Nervous System
32
6
DOI
出版ステータス出版済み - 6 1 2016

All Science Journal Classification (ASJC) codes

  • 小児科学、周産期医学および子どもの健康
  • 臨床神経学

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