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Multicenter comparison of Chiari malformation type I presentation in children versus adults
Journal article   Peer reviewed

Multicenter comparison of Chiari malformation type I presentation in children versus adults

Armin Mortazavi, Neil D Almeida, Katherine Hofmann, Laurence Davidson, Juliana Rotter, Tiffany N Phan, Deki Tsering, Christina Maxwell, Jehshua Karunakaran, Erol Veznedaroglu, …
Journal of neurosurgery. Pediatrics, v 34(1), pp 49-56
01 Jul 2024
DOI: https://doi.org/10.3171/2023.12.PEDS22366
PMID: 38394661
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC11369763/pdf/nihms-2017067.pdfView
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Abstract

Adolescent Adult Age Factors Arnold-Chiari Malformation - complications Arnold-Chiari Malformation - diagnostic imaging Arnold-Chiari Malformation - surgery Child Child, Preschool Decompression, Surgical - methods Female Humans Male Middle Aged Retrospective Studies Scoliosis - diagnostic imaging Scoliosis - surgery Syringomyelia - complications Syringomyelia - diagnostic imaging Syringomyelia - surgery Treatment Outcome Young Adult
Treatment for Chiari malformation type I (CM-I) often includes surgical intervention in both pediatric and adult patients. The authors sought to investigate fundamental differences between these populations by analyzing data from pediatric and adult patients who required CM-I decompression. To better understand the presentation and surgical outcomes of both groups of patients, retrospective data from 170 adults and 153 pediatric patients (2000-2019) at six institutions were analyzed. The adult CM-I patient population requiring surgical intervention had a greater proportion of female patients than the pediatric population (p < 0.0001). Radiographic findings at initial clinical presentation showed a significantly greater incidence of syringomyelia (p < 0.0001) and scoliosis (p < 0.0001) in pediatric patients compared with adult patients with CM-I. However, presenting signs and symptoms such as headaches (p < 0.0001), ocular findings (p = 0.0147), and bulbar symptoms (p = 0.0057) were more common in the adult group. After suboccipital decompression procedures, 94.4% of pediatric patients reported symptomatic relief compared with 75% of adults with CM-I (p < 0.0001). Here, the authors present the first retrospective evaluation comparing adult and pediatric patients who underwent CM-I decompression. Their analysis reveals that pediatric and adult patients significantly differ in terms of demographics, radiographic findings, presentation of symptoms, surgical indications, and outcomes. These findings may indicate different clinical conditions or a distinct progression of the natural history of this complex disease process within each population, which will require prospective studies to better elucidate.

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5 citations in Web of Science
4 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Pediatrics
Surgery
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