Мальформация Арнольда–Киари: классификация, этиопатогенез, клиника, диагностика (обзор литературы)

Lyudmila Dzyak; Mykola Zorin; V. Egorov; Yuri Cherednychenko

Authors

Lyudmila Dzyak Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine
Mykola Zorin Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine
V. Egorov Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine
Yuri Cherednychenko Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine

Keywords:

Arnold-Chiari malformation, the posterior cranial fossa, syringomyelia

Abstract

The review of works devoted to Arnold-Chiari malformation (ACM) is carried out. Problems of classification, related pathology and the degree of it correlation with the malformation, theory of etiology and pathogenesis, the course of disease are considered. ACM I type is accompanied by syrinx at 60-70% of cases, ACM II and ACM III types – at 30-75%. Research, demonstrating that syrinx is filled from subarachnoid space through microchannels in substance of spinal cord, but not from the fourth ventricle, is observed. Malformation of the second type is accompanied by lumbosacral meningocele, and that of the third type – by cervical myelomeningocele or occipital encephalocele at 100% cases. On the other hand, inborn meningocele enables us to think about associated ACM of the second type. Magnetic resonance tomography is the method, which solved the problem of diagnostics of ACM. Nevertheless we haven’t common criteria of diagnostics of ACM till now.

References

Ахадов Т.А., Сачкова И.Ю., Кравцов А.К. и др. Аномалия Арнольда–Киари: Данные магнитно-резонансной томографии и клинические проявления //Журн. неврологии и психиатрии. – 1993. – №5. – С. 19–23.

Ахадов Т.А., Белов С.А., Кравцов А.К. и др. Ядерно-магнитная томография в дифференциальной диагностике сирингобульбии и краниоспинальных опухолей // Вестн. рентгенологии и радиологии. – 1993. – №2.–С. 43–46.

Благодатский М.Д., Александров Ю.А., Ларионов С.Н. и др. Ультразвуковое исследование головного мозга у детей раннего возраста с мальформацией Арнольда–Киари // Педиатрия. –1994. – №5. –С. 87–90.

Егоров О.Е., Евзиков Г.Ю. Клиника и хирургическое лечение аномалии Киари 1-го типа //Неврол. журн.–1999.– № 5.–С. 28–31.

Йорданов Б., Янков Я. Редкие синдромы и заболевания нервной системы.– М.: Медицина, 1981.– 101с.

Лобзин В.С., Полякова В.А., Сидорова Т.Г., Голимбиевская Т.А. Неврологические синдромы при краниовертебральных дисплазиях// Журн. неврологии и психиатрии.– 1988. – №9.– С. 12–16.

Макаров А.Ю., Холин А.В., Крицкая Л.А. Метод магнито-резонансной терапии в диагностике сирингомиелии // Вопр. нейрохирургии.–1991.–№6.– С. 18–21.

Парамонов Л.В. Кистография спинного мозга в определении тактики хирургического лечения сирингомиелий // Вопр. нейрохирургии.–1983.–№5.–С. 8–12.

Шустин В.А., Говенько Ф.С. Диагностика и лечение аномалии краниовертебральной области с развитием синдрома Арнольда–Киари и гидромиелии //Журн. неврологии и психиатрии.–1997.– №12.–С.62–64.

Ahmmed A.U., Mackenzie I., Das V.K. et al. Audio-vestibular manifestations of Chiari malformation and outcome of surgical decompression: a case report //J. Laryngol. Otol.–1996.–P. 1060–1064.

Alvarez D., Requena I., Arias M. et al. Acute respiratory failure as the first sign of Arnold-Chiari malformation associated with syringomyelia //Eur. Respir. J.–1995.–V.8.–P.661–663.

Amer T.A., el-Shmam O.M. Chiari malformation type I: a new MRI classification //Magn. Reson. Imaging.– 1997.–V.15.–P. 397–403.

Bindal A.K., Dunker S.B., Tew J.M. Chiari I malformation: classification and management //Neurosurg.–1995.–V.37.–P.1069–1074.

Caban L., Bentson J. Considerations in the diagnosis and treatment of syringomyelia and the Chiari malformation //J. Neurosurg.–1982.– V.57.–P.24–31.

Cai C., Oakes W.J. Hindbrain herniation syndromes. The Chiari malformations (I and II) //Semin. Pediatr. Neurol.–1997.–V.4.–P.179-191.

Carmel P. Pediatric Neurosurgery Surgery of the Developing Nervous System.–New York: Grune & Stratton, 1982.– P. 61-77.

Carmel P., Marksberry W. Early descriptions of Arnold–Chiari malformation. The contribution of John Cleland //J. Neurosurg.–1972.–V.37.–P.543–547,

Cavender R.K., Schmidt J.H. Tonsillar ectopia and Chiari malformations: monozygotic triplets //J. Neurosurg .–1995.–V.82.–P.497–500,

Dyste G.N., Menezes A.H., VanGilder J.C. Symptomatic Chiari malformations. An analysis of presentation, managment, and long-term outcome //J. Neurosurg.–1989.–V.71.–P.159–168.

Elster A.D., Chen M.U.M. Chiari I malformations: clinical and radiologic reappraisal //Radiology.–1992.– V.183.–P.347–353.

Elta G.H., Caldwell C.A., Nostrant T.T. Esophageal dysphagia as the sole symptom in type I Chiari malformation //Dig. Dis. Sci.–1996.–V. 41.–P.512–515.

Ikusaka M., Iwata M., Sasaki S., Uchiyama S. Progressive dysphagia due to adult Chiari I malformation mimicking amyotrophic lateral sclerosis //J. Neurol. Neurosurg. Psychiatry.–1996.–V.60.–P.357–358.

Ireland P.D., Mickelsen D., Rodenhouse T.G. et al. Evaluation of the autonomic cardiovascular response in Arnold-Chiari deformities and cough syncope syndrome //Arch. Neurol.–1996.–V.53.–P.526–531.

Lee M., Rezai A.R., Wisoff J.H. Acquired Chiari-I malformation and hydromyelia secondary to a giant craniopharyngioma //J. Pediatr. Neurosurg.–1995.–V.22 (5).–P.251–254.

Levy W.J., Mason L., Hahn J. Chiari malformation presenting in adults: a surgical experience of 127 cases //J. Neurosurg.–1983.–V.12(2).–P.377–390.

Marin-Padilla M. Notochordal-basichondro¬cranium relationships: abnormalities in experimental axial skeletal (dysraphic) disorders //J. Embryol. Exp. Morphol.–1979.–V.53–P.15–38.

Marin-Padilla M., Marin-Padilla T.M. Morphogenesis of experimentally induced Arnold-Chiari malformation //J. Neurol. Sci.–1981.–V.50.–P.29–55.

Mikulis D.J., Diaz O., Egglin T.K., Sanchez R. Variance of the cerebellar tonsils with age: preliminary report //Radiology.–1992.–V.183.–P.725–728.

Morioka T., Shono T., Nishio S. et al. Acquired Chiari I malformation and syringomyelia associated with bilateral chronic subdural hematoma. Case report //Neurosurg.–1995.–V.83(3).– P.556–58.

Naidich T.P., McLone D.G., Harwood-Nash D.C. Spinal dysraphisms. – Newton TH, Potts DG, editors: Computed Tomog¬raphy of the Spine and Spinal Cord.–P.299–353. –San Anselmo, Clavadel Press–1983.

Naidich T.P. Chiari II malformation. – Weinberg PE, editor: Neuroradiology Test and Syllabus–part 1–set.28 – P.213–215. – American College of Radiology Professional Self-evalution and Continuing Education Program, Reston–1990.

Perdue J., Mahon N., Hawes S. et al. Chronic Care Nursing.– New York: Springer Publishing Co., 1981.

Pillay P.K., Awad I.A., Little J.R., Hahn J.F. Symptomatic Chiari malformation in adults: a new classification based on magnetic resonance imaging with clinical and prognostic significance //Neurosurgery.–1991.–V.28.–P.639–645.

Rhoton A.L. Microsurgery of syringomyelia and syringomyelic cord syndrome //Operative Neurosurgical Techniques.–1982.–V.1.–P.103–124.

Sakamoto H., Nishikawa M., Nakanishi N. et al. Surgical treatment of syringomyelia associated with Chiari malformation //Spinal Surg.(Jpn) –1994.–V.8.–P.1–6.

Schmidt H., Sartor K., Heckl R.W. Bone malformations of the craniocervical region. – Editors: Vinken P.J., Bruyn G.W.: Handbook of Clinical Neurology.–V. 32.–Congenital Malformations of the Spine and Spinal Cord–Amsterdam. – Elsevier/North-Holland, 1978.– P.1–98.

Shiihara T., Shimizu Y., Mitsui T. et al. Isolated sleep apnea due to Chiari type I malformation and syringomyelia //Pediatr. Neurol.–1995.–V.13.–P.266–267.

Stark J.E, Clasier CM: MR demonstration of ectopic fourth ventricular choroid plexus in Chiari II malformation //Amer.J.NR.– 1993. – V.14.–P.618–621.

Storrs T.J., Roberts C.I. Adult Chiari malformation with headache and trigeminal dysesthesia. //Oral. Surg. Oral. Med. Oral. Pathol. Oral. Radiol. Endod.–1996.–V.82.–P.284–287.

Zadeh H.G., Sakka S.A., Powell M.P., Mehta M.H. Absent superficial abdominal reflexes in children with scoliosis. An early indicator of syringomyelia //J. Bone Joint Surg. Br.–V.77.–P.762–767.