Синдромы нейроваскулярной компрессии образований задней черепной ямки в сочетании с аномалией Киари

V. O. Fedirko

doi:10.25305/unj.128202

Authors

V. O. Fedirko Romodanov Neurosurgery Institute, Kiev, Ukraine

DOI:

https://doi.org/10.25305/unj.128202

Keywords:

neurovascular compression syndromes, the posterior cranial fossa, the deletion of the cerebellar tonsils into the spinal canal, the anomaly Chiari

Abstract

The results of clinical and MRI investigation as to the peculiarities of posterior cranii fossa (PCF) parameters, appropriate for the small PCF and frequency of Chiari malformation in 220 patients with neurovascular compression syndrome (trigeminal and glossopharyngeal neuralgie, hemifacial spasm, Meniere’s syndrome, essential paroxysmal arterial hypertention) are presented. The surgical tactics in neurovascular compression syndrome combined with Chiari malformation are discussed. Decompression of craniocervical conduct simultaneously with microvascular decompression (MVD) surgery were performed in 7 patients. MVD was performed in 2 patients followed by PCF because of growing signs of tonsillar herniation. PCF decompression was performed in 2 patients before MVD. Only craniocervical conduct showed resolution of trigeminal neuralgia without MVD surgery in one case. Signs of cerebellar herniation have been resolved in all 12 patients after craniocervical conduct decompression, like signs of cranial nerves compression after MVD.

References

Крупина Н.Е., Белодед В.М., Широкова Е.И., Сорокина В.А. Мультифакторный характер мальформации Киари I типа // Журн. неврологии и психиатрии им. С.С. Корсакова. — 2002. — №2. — C.23–26.

Махмудов У.Б., Салалыкин В.И., Шиманский В.Н. и др. Компрессия продолговатого мозга задней нижней мозжечковой артерией при мальформации Арнольда–Киари как причина артериальной гипертензии // Вопр. нейрохирургии. — 2001. — №3. — C.22–23.

Aboulezz A.O., Sartor K., Geyer C.A., Gado M.H. Position of cerebellar tonsils in the normal population and in patients with Chiari malformation: A quantitative approach with MR imaging // J. Comput. Assist. Tomogr. — 1985. — V.9. — P.1033–1036.

Barkovich A.J., Wippold J.F., Sherman J.L., Citrin C.M. Significance of cerebellar tonsillar position on MR // Am. J. Neuroradiol. — 1986. — V.7. — P.795–799.

Braca J., Hornyak M., Murali R. Hemifacial spasm in a patient with Marfan syndrome and Chiari I malformation. Case report // J. Neurosurg. — 2005. — V.103. — P.552–554.

Cavender R., Schmidt J. Tonsillar ectopia and Chiari malformations: monozygotic triplets. Case report // J. Neurosurg. — 1995. — V.82. — P.493–500.

Ivanez V., Moreno M. Trigeminal neuralgia in children as the only manifestation of Chiari I malformation // Rev. Neurol. — 1999. — V.28, N5. — P.485–487.

Kobata H., Kondo A., Iwasaki K., Nishioka T. Combined hyperactive dysfunction syndrome of the cranial nerves: trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: 11-year experience and review // Neurosurgery. — 1998. — V.43, N6. — P.1351–1362.

Masopust V., Netuka D., Benes V. Constitutionally small posterior fossa as a predisposition for neurovascular conflict // J. Neurosurg. — 2002. — V.96. — P.190A.

McLaughlin M.R., Jannetta P.J., Clyde B.L. et al. Microvascular decompression of cranial nerves: lesions learned after 4400 operations // J. Neurosurg. — 1999. — V.90. — P.1–8.

Meadows J., Kraut M., Guarnieri M. et al. Asymptomatic Chiari type I malformations identified on magnetic resonance imaging // J. Neurosurg. — 2000. — V.92. — P.920–926.

Moller A.R. Cranial nerve dysfunction syndromes: pathophysiology of microvascular comporession // Neurosurgical topics Book 13. Surgery of Cranial nerves of the Posterior Fossa / Ed. D.L. Barrow. Am. Assoc. Neurolog. Surg. — Park Ridge, Illinois: 1993. — Chapter 2. — P.105–129.

Rosetti P., Ben Taib N.O., Brotchi J., De Witte O. Arnold Chiari type I malformation presenting as a trigeminal neuralgia: Case report // Neurosurgery. — 1999. — V.44, N5. — P.1122–1124.

Shaya M., Jawahar A., Caldito G. et al. Gamma knife radiosurgery for trigeminal neuralgia: A study of predictors of success, efficacy, safety, and outcome at LSUHSC // Surg. Neurol. — 2004. — V.61. — P.529–535.