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Secondary Interventions for Chiari I Malformation

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The Chiari Malformations

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Abstract

Patients with Chiari I malformations may present again after a foramen magnum decompression for two reasons: either they are unsatisfied with the result or new neurological symptoms have appeared. This chapter provides a systematic approach to these patients. As a general rule, revision surgery should be reserved for patients with progressive neurological symptoms. Arachnoid scarring causing obstructions of cerebrospinal fluid (CSF) flow was the commonest intraoperative finding in such revisions. Craniocervical instability in patients with basilar invagination or Klippel-Feil syndromes is the other potential mechanism leading to postoperative deterioration after a foramen magnum decompression. In such patients, a revision has to include stabilization. Apart from these foramen magnum-related mechanisms, degenerative diseases of the cervical spine may lead to signs of a cervical myelopathy requiring early surgery. With revision surgeries, no major postoperative improvements should be expected. Stabilization of the neurological state is the realistic outlook.

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Authors and Affiliations

  1. Department of Neurosurgery, Christliches Krankenhaus Quakenbrück, Quakenbrück, Lower Saxony, Germany

    Jörg Klekamp

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  1. Jörg Klekamp
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Correspondence to Jörg Klekamp .

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Editors and Affiliations

  1. Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA

    R. Shane Tubbs

  2. Department of Neurosurgery, Aydın Adnan Menderes University School of Medicine, Efeler, Aydın, Turkey

    Mehmet Turgut

  3. Departments of Neurosurgery and Pediatrics, University of Alabama, Birmingham, AL, USA

    W. Jerry Oakes

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Klekamp, J. (2020). Secondary Interventions for Chiari I Malformation. In: Tubbs, R., Turgut, M., Oakes, W. (eds) The Chiari Malformations. Springer, Cham. https://doi.org/10.1007/978-3-030-44862-2_44

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  • DOI: https://doi.org/10.1007/978-3-030-44862-2_44

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44861-5

  • Online ISBN: 978-3-030-44862-2

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