In response to this article

[Guest guest]

In a message dated 9/10/99 1:02:33 AM Eastern Daylight Time, WYVERNNC@...

writes:

<<

OBJECTIVE AND IMPORTANCE: We present the cases of three patients in whom

pseudomeningocele (PSM) formations after posterior fossa decompression of

hindbrain herniations (Chiari I malformations) were associated with

persistence of syringomyelia. The physiological importance of correcting

this

>>

I found this article very interesting when I was reading it as I have had a

pseudomeningocele removed that was unexpectively found when I was opened up

for the fourth time in January of 1999.

My first surgery was in 1993 for Chiari II and I had a suboccipital

craniotomy, dural graft and laminectomies of C1 and C2. I had to have

further surgery in November of 1997 when the diagnosis of Basilar

Invagination was found. It was on the original MRI but was not diagnosed. I

had two surgeries at Duke for the Basilar Invagination which were not

successful and ended up with a third one in VA that was successful. My

herniation of the tonsils were measured at 12 mm and the brainstem at 12 mm

too. Makes you wonder if they had done the surgery for the BI if I would

have even needed the decompression.

What is good about this article to me is the note about different authors

coming up with alternative methods to measure BI and Chiari besides Milhorat,

Green, Frim and Menezes. I am sure that I have left some of the other

doctors out, but the gist of this is that the more we see new and different

names getting their articles published the better chance we are going to be

diagnosed quicker and with more precision in what to do for surgical

intervention.

Hope this is a good day for you.

Sue Marsigli

ok part 3 , so im not sure why so much has been coming out garbled , done my

best to ungarble it now , ......again i couldnt rescue many of those id

copied , so you may want to do that search yourself . hugs , .......sarah in

paradise \

Syringomyelia persistence after Chiari decompression as a result of

pseudomeningocele formation: implications for syrinx pathogenesis: report of

three cases.

Pare LS, Batzdorf U

Division of Neurosurgery, University of California, Los Angeles Medical

Center, 90095-6901, USA.

OBJECTIVE AND IMPORTANCE: We present the cases of three patients in whom

pseudomeningocele (PSM) formations after posterior fossa decompression of

hindbrain herniations (Chiari I malformations) were associated with

persistence of syringomyelia. The physiological importance of correcting this

complication has not been previously described. CLINICAL PRESENTATION: We

identified three patients who developed suboccipital PSMs after undergoing

posterior fossa decompression for hindbrain herniations and syringomyelia.

All three patients experienced persistence of their symptoms and their

syringomyelia, despite adequate posterior fossa decompression. TECHNIQUE:

Subsequent exploration revealed cerebrospinal fluid leaking either from the

dural suture line (one patient) or from perforations found within the bed of

a polyglactin mesh dural graft (two patients). Correction of the PSM resulted

in resolution of both the syringomyelia and the symptoms in all three

patients. DISCUSSION: The persistence of syringomyelia in the presence of a

PSM may be the result of dissipation of the cerebrospinal fluid systolic

pressure wave into the distensible PSM cavity. This phenomenon suggests that

the cerebrospinal fluid pressure exerted on the spinal cord surface favors

resolution of the syrinx cavity.

PMID: 9766325, UI: 98437715

------------------------------------------------------------------------

the above report in format

documents on this page through Loansome Doc

------------------------------------------------------------------------

Other Formats: