Symptom recurrence after suboccipital decompression for pediatric Chiari I malformation

Analysis of 256 consecutive cases

Matthew J. McGirt, Frank J. Attenello, April Atiba, Giannina Garces-Ambrossi, Ghazala Datoo, Jon David Weingart, Benjamin Solomon, George Jallo

Research output: Contribution to journalArticle

Abstract

Objective: Symptom recurrence remains a problem for some patients after surgical decompression for Chiari I malformation. We set out to identify variables at presentation that could identify subgroups most likely to experience incomplete symptom relief after hindbrain decompression for Chiari I malformation. Materials and methods: We retrospectively reviewed the records of all pediatric patients undergoing first-time suboccipital decompression for Chiari I malformation over a 10-year period. Measured outcomes included (1) persistence or recurrence of symptoms regardless of severity and (2) need for revision decompression. Results: Two hundred fifty-six children (10 5years old) underwent surgery for Chiari I malformation and were followed up for a mean of 27months. Presenting symptoms included headache in 192 (75%) patients and brainstem or cranial nerve symptoms in 68 (27%) patients. Fifty-seven (22%) patients experienced mild to moderate symptom recurrence. Nineteen (7%) patients required revision decompression for significant symptom recurrence. Headache was 70% more likely to persist or recur versus cranial nerve or brainstem symptoms (relative risk 1.70, p

Original languageEnglish (US)
Pages (from-to)1333-1339
Number of pages7
JournalChild's Nervous System
Volume24
Issue number11
DOIs
StatePublished - 2008

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Decompression
Pediatrics
Recurrence
Cranial Nerves
Brain Stem
Headache
Surgical Decompression
Rhombencephalon

Keywords

  • Chiari malformation
  • Outcome
  • Predictors
  • Risk factors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Symptom recurrence after suboccipital decompression for pediatric Chiari I malformation : Analysis of 256 consecutive cases. / McGirt, Matthew J.; Attenello, Frank J.; Atiba, April; Garces-Ambrossi, Giannina; Datoo, Ghazala; Weingart, Jon David; Solomon, Benjamin; Jallo, George.

In: Child's Nervous System, Vol. 24, No. 11, 2008, p. 1333-1339.

Research output: Contribution to journalArticle

McGirt, Matthew J. ; Attenello, Frank J. ; Atiba, April ; Garces-Ambrossi, Giannina ; Datoo, Ghazala ; Weingart, Jon David ; Solomon, Benjamin ; Jallo, George. / Symptom recurrence after suboccipital decompression for pediatric Chiari I malformation : Analysis of 256 consecutive cases. In: Child's Nervous System. 2008 ; Vol. 24, No. 11. pp. 1333-1339.
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