ARNOLD-CHİARİ MALFORMASYONU

Abstract

Arnold-Chiari veya kısaca Chiari malformasyonu; serebellumun tonsillerinin foramen magnum yoluyla aşağıya servikal spinal kanal içerisine hernie olması ile karaktarizedir ve malformasyona intrakranial veya ekstrakranial gelişimsel defektler eşlik edebilir. Posterior fossa ve orta beyni (serebellumun tonsilleri, pons ve medulla oblangatayı) ilgilendiren bu deformite grubu çocuk ve yetişkinlerde farklı şiddetlerde anatomik defektler ve morfolojilerine göre sınıflandırılır. Bu derleme çalışmasında, Chiary malformasyonun sınıflandırması, etyolojisi, epidemiyolojisi ve patofizyolojisi gözden geçirilmiştir. Klinik semptom ve bulgular ile ayırıcı teşhisi ve nörogörüntüleme parametreleri derlenerek, tedavi yaklaşımları literatüre dayanarak sunulmuştur.

Keywords

• Arnold-Chiari
• malformasyon
• serebellum
• Foremen Magnum
• Orta beyin

References

1. Arruda JA, Figueiredo E, Monteiro JL, Barbosa LM, Rodrigues C, Vasconcelos B. Or ofacial clinical features in Arnold Chiari type I malformation: A case series. J Clin Exp Dent. 2018 Apr;10(4):e378-e382.
2. Bhimani AD, Esfahani DR, Denyer S, Chiu RG, Rosenberg D, Barks AL, Arnone GD, Mehta AI. Adult Chiari I Malformations: An Analysis of Surgical Risk Factors and Complications Using an International Database. World Neurosurg. 2018 Jul;115:e490-e500.
3. Kandeger A, Guler HA, Egilmez U, Guler O. Major depressive disorder comorbid severe hydrocephalus caused by Arnold-Chiari malformation. Indian J Psychiatry. 2017 OctDec;59(4):520-521.
4. Carmel P, Marksberry W: Early descriptions of Arnold-Chiari malformation. The contribution of John Cleland. J Neurosurg 37: 543-547, 1972
5. Chiari H: Über Veränderungen des kleinhirns infolge von hydrocephalie des grosshirns. Dtsch Med Wochenschr 17: 1172-1175,1891
6. Chiari H: Über Veranderungen des kleinhirns, des Pons und der Medulla oblongota in Folge von congenitaler Hydrocephalie Grosshirns. Denkschr. Akad Wiss Wien 63: 71, 1895
7. Isu T, Sasaki H, Takamura H, Koboyashi N: Foramen magnum decompression with removal of the outer later of the dura as treatment for syringomyelia occurring with Chiari malformations. Neurosurgery 33: 845-850, 1993
8. Iskandar BJ, Hedlund GL, Grabb PA, Oakes WJ. The resolution of syringohydromyelia without hindbrain herniation after posterior fossa decompression. J Neurosurg. 1998 Aug;89(2):212-6.

9. Kim IK, Wang KC, Kim IO, Cho BK. Chiari 1.5 malformation : an advanced form of Chiari I malformation. J Korean Neurosurg Soc. 2010 Oct;48(4):375-9.
10. Tubbs RS, Muhleman M, Loukas M, Oakes WJ. A new form of herniation: the Chiari V malformation. Childs Nerv Syst. 2012 Feb;28(2):305-7.
11. Giammattei L, Borsotti F, Parker F, Messerer M. Chiari I malformation: surgical technique, indications and limits. Acta Neurochir (Wien). 2018 Jan;160(1):213-217.
12. Hentati A, Badri M, Bahri K, Zammel I. Acquired Chiari I malformation due to lumboperitoneal shunt: A case report and review of literature. Surg Neurol Int. 2019;10:78.
13. Yan H, Han X, Jin M, Liu Z, Xie D, Sha S, Qiu Y, Zhu Z. Morphometric features of posterior cranial fossa are different between Chiari I malformation with and without syringomyelia. Eur Spine J. 2016 Jul;25(7):2202-9.
14. Markunas CA, Enterline DS, Dunlap K, Soldano K, Cope H, Stajich J, Grant G, Fuchs H, Gregory SG, Ashley-Koch AE. Genetic evaluation and application of posterior cranial fossa traits as endophenotypes for Chiari type I malformation. Ann Hum Genet. 2014 Jan;78(1):1-12.
15. Speer MC, George TM, Enterline DS, Franklin A, Wolpert CM, Milhorat TH. A genetic hypothesis for Chiari I malformation with or without syringomyelia. Neurosurg Focus. 2000 Mar 15;8(3):E12.
16. Abbott D, Brockmeyer D,Neklason DW, Teerlink C,Cannon-AlbrightLA.Population-based description of familial clustering of Chiari malformation Type I. J Neurosurg. 2018 Feb;128(2):460-465.
17. Boyles AL, Enterline DS, Hammock PH, Siegel DG, Slifer SH, Mehltretter L, Gilbert JR, Hu-Lince D, Stephan D, Batzdorf U, Benzel E, Ellenbogen R, Green BA, Kula R, Menezes A, Mueller D, Oro’ JJ, Iskandar BJ, George TM, Milhorat TH, Speer MC. Phenotypic definition of Chiari type I malformation coupled with high-density SNP genome screen shows significant evidence for linkage to regions on chromosomes 9 and Am J Med Genet A. 2006 Dec 15;140(24):2776-85.
18. Langridge B, Phillips E, Choi D. Chiari Malformation Type 1: A Systematic Review of Natural History and Conservative Management. World Neurosurg. 2017 Aug;104:213-219.
19. Hidalgo JA, Tork CA, Varacallo M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): May 4, 2021.
20. Dlouhy BJ, Dawson JD, Menezes AH. Intradural pathology and pathophysiology associated with Chiari I malformation in children and adults with and without syringomyelia. J Neurosurg Pediatr. 2017 Dec;20(6):526-541.
21. Tubbs RS, Beckman J, Naftel RP, Chern JJ, Wellons JC, Rozzelle CJ, Blount JP, Oakes WJ. Institutional experience with 500 cases of surgically treated pediatric Chiari malformation Type I. J Neurosurg Pediatr. 2011 Mar;7(3):248-56.
22. Elster AD, Chen MY. Chiari I malformations: clinical and radiologic reappraisal. Radiology.1992 May;183(2):347-53.
23. Jokonya L, Makarawo S, Mduluza-Jokonya TL, Ngwende G. Fatal status migrainosus in Chiari 1 malformation. Surg Neurol Int. 2019;10:243.
24. Greenlee JD, Donovan KA, Hasan DM, Menezes AH. Chiari I malformation in the very young child: the spectrum of presentations and experience in 31 children under age 6 years. Pediatrics. 2002 Dec;110(6):1212-9.
25. García M, Lázaro E, López-Paz JF, Martínez O, Pérez M, Berrocoso S, Al-Rashaida M, Amayra I. Cognitive Functioning in Chiari Malformation Type I Without Posterior Fossa Surgery. Cerebellum. 2018 Oct;17(5):564-574.
26. Giammattei L, Borsotti F, Parker F, Messerer M. Chiari I malformation: surgical technique, indications and limits. Acta Neurochir (Wien). 2018 Jan;160(1):213-217.