Arnold Chiari畸形脑脊液动力学改变的临床观察

Clinic study of CSF dynamics of Arnold Chiari malformation

目的 从临床上验证ArnoldChiari畸形 (ACM)合并脊髓空洞 (SM )的脑脊液 (CSF)动力学改变的理论 ,提高ACM -SM的治愈率。方法 通过对 3 8例ACM -SM进行 1年的术前观察和显微手术治疗。结果 3 8例ACM -SM中术前ACM或 (和 )SM进行性发展 3 0例 ( 78 95 % ) ,术后临床症状改善 3 5例 ( 92 11% ) ,并进行术后 1年随访 ,获得随访 2 9例 ,SM消失 2 0例 ,空洞明显缩小 9例。结论 ACM的CSF动力学改变是ACM合并SM的主要原因 ,手术在行后颅窝减压的基础上显微镜下松解下疝组织的粘连 ,恢复脑脊液循环是有效治疗ACM -SM的关键。

Objective To prove the theory of CSF dynamics change for Arnold chiari malformation with syringomyelia by clinic and to enhance the rate of cure.Methods 38 cases were observed one year in preoperation and treated by microsurgery operation.Results 30 cases in 38 ACM and SM have been exacerbated in progress(78.95%),of 35 cases clinic symptoms have been improved after operation(92.11%).29 cases were followed-up in one year after operation,of 20 cases syringomyelia have been disappeared,of 9 cases were reduced apparently.Conclusion The dynamic change of CSF is the first cause for ACM to complicate SM.Removing the adhere of cerebreallum tonsil with surrounding and restructing CSF circulation are the key to treat ACM-SM depend on basis of postfossa decompression