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tonsillar_herniation

Tonsillar herniation

It has been well documented that, along with tonsillar herniation, Chiari Malformation Type I (CMI) is associated with smaller posterior cranial fossa (PCF) and altered cerebrospinal fluid (CSF) flow and tissue motion in the craniocervical junction.

CM-I in children is not a radiologically static entity but rather is a dynamic one. Radiological changes were seen throughout the 7 years of follow-up. A reduction in tonsillar herniation was substantially more common than an increase. Radiological changes did not correlate with neurological examination finding changes, symptom development, or the need for future surgery. Follow-up imaging of asymptomatic children with CM-I did not alter treatment for any patient. It would be reasonable to follow these children with clinical examinations but without regular surveillance MRI 1).


As subdural empyema SDE along the tentorial surface may remain undetected in axial sections of CT scans, a lumbar puncture may precipitate fatal tonsillar herniation

1)
Whitson WJ, Lane JR, Bauer DF, Durham SR. A prospective natural history study of nonoperatively managed Chiari I malformation: does follow-up MRI surveillance alter surgical decision making? J Neurosurg Pediatr. 2015 Aug;16(2):159-66. doi: 10.3171/2014.12.PEDS14301. Epub 2015 May 1. PubMed PMID: 25932776.
tonsillar_herniation.txt · Last modified: 2015/12/27 13:21 (external edit)