Objective To observe the morphological changes of subarachnoid space(SS) at craniocervical junction(CCJ) in patients with type I Chiari malformation(CM I) accompanied by syringomyelia(SM) after the operation, and to study the pathogenesis of CM-SM. Methods The magnetic resonance images (MRI) in 34 CM I patients were reviewed. Twenty-seven patients underwent posterior fossa decompression with duraplasty (PFDD), and another 7 patients underwent posterior fossa decompression without duraplasty (PFD), and 23/34 were followed up by MRI. The extent of cerebellar tonsillar hernia (ECT), the α angle between clivus and the floor of the fourth ventricle, the volumes of the posterior cranial fossa(PCF), CCJ and SS on the sagital MRI were measured separately. Results Cerebellar tonsils elevated 10.07 mm,α angle increased by 1.95°, the PCF and CCJ volume increased by 11.29 ml and 6.29 ml respectively after procedure. The SS volume in CCJ region increased 14.44 ml (2.2 times that before procedure). These changes were of statistical difference compared with pre-procedure (P<0.05). The effective rate of PFDD (by a mean of 96.3%) was significant higher than that of PFD (by a mean of 71.4%)(P<0.05〉. Conclusions The narrowing of SS plays an important role in the pathogenesis of SM-CM. It is proved that PFDD for the treatment of CM-SM is preferred.
Key words
Type I Chiari malformations /
syringomyelia /
subarachnoid space /
posterior fossa decompression /
duraplasty
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(2012-07-15
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