Frontal Porensefalik Kiste Bağlı Gelişen Edinsel Chiari Malformasyonu Vakası: Kisto-Peritoneal Shunt İle Başarılı Yönetim
Özet
Bu çalışmada, basınçlı porensefalik kiste bağlı gelişen edinilmiş Chiari malformasyonu (ECM) vakası sunulmuştur. 39 yaşındaki kadın hasta, baş ağrısı, baş dönmesi, dengesizlik ve yürüme bozukluğu şikayetleriyle polikliniğe başvurdu. Hastanın anamnezinde 15 yıl önce beyin tümörü nedeniyle ameliyat olduğu öyküsü bulunmaktaydı. Beyin magnetik rezonans görüntüleme incelemelerinde, porensefalik kist, Chiari malformasyonu ve siringomyeli tespit edildi. Hastaya genel anestezi altında kisto-peritoneal şant uygulandı. Operasyon sonrası hastanın semptomları tamamen geriledi. Bir yıl sonra yapılan radyolojik kontrollerde serebellar tonsillerin geri çekildiği ve syringomyelinin gerilediği gözlendi. Sonuç olarak, ECM’nin tedavisinde primer lezyonun düzeltilmesiyle başarılı sonuçlar elde edilebileceği gösterilmiştir.
This study presents a case of acquired Chiari malformation (ACM) caused by a pressurized porencephalic cyst. A 39-year-old female patient presented to the clinic with complaints of headache, dizziness, imbalance, and walking difficulty. The patient's medical history revealed that she had undergone surgery for a brain tumor 15 years ago. Brain magnetic resonance imaging revealed a porencephalic cyst, Chiari malformation, and syringomyelia. The patient underwent a cysto-peritoneal shunt procedure under general anesthesia. Postoperatively, the patient's symptoms completely resolved. One year later, follow-up imaging showed retraction of the cerebellar tonsils and regression of syringomyelia. In conclusion, successful outcomes in the treatment of ACM can be achieved by addressing the primary lesion.
Referanslar
Kular S, Cascella M. Chiari Malformation Type 1. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 9, 2024.
Erdoğan O, Sarıca C. Chiari Malformasyonları. Türk Nöroşirürji Dergisi. 31(1):57-63, 2021.
Doğu H, Özdemir AA. The Use of Fibrin Sealant in Chiari Malformation Type-1 Surgery; Is It Effective in Preventing the Formation of CSF Fistula? Ulutas Med J. 2019;5(1):65-70.
Atkinson JL. Resolution of tonsillar herniation after supratentorial tumor resection: case report and review of the literature. Neurosurgery. 2001;48(3):702-704. doi:10.1097/00006123-200103000-00063.
Di Rocco C, Velardi F. Acquired Chiari type I malformation managed by supratentorial cranial enlargement. Childs Nerv Syst. 2003;19(12):800-807. doi:10.1007/s00381-003-0837-7.
Wang J, Alotaibi NM, Samuel N, Ibrahim GM, Fallah A, Cusimano MD. Acquired Chiari Malformation and Syringomyelia Secondary to Space-Occupying Lesions: A Systematic Review. World Neurosurg. 2017;98:800-808.e2. doi:10.1016/j.wneu.2016.11.080.
Hajtovic S, Placantonakis DG. Resolution of Tonsillar Herniation and Syringomyelia Following Resection of a Large Anterior Frontal Parasagittal Meningioma. Cureus. 2020;12(4). doi:10.7759/cureus.7636.
Onesti ST, Ashkenazi E, Miller AM, Michelsen WJ. Resolution of acquired tonsillar herniation after resection of supratentorial meningioma. Case illustration. J Neurosurg. 1997;86(3):572. doi:10.3171/jns.1997.86.3.0572.
Sheehan JM, Jane JA Sr. Resolution of tonsillar herniation and syringomyelia after supratentorial tumor resection: case report and review of the literature. Neurosurgery. 2000;47(1):233-235. doi:10.1097/00006123-200007000-00050.
Thotakura AK, Marabathina NR. Acquired Chiari I Malformation with Syringomyelia Secondary to Colloid Cyst with Hydrocephalus - Case Report and Review of Literature. World Neurosurg. 2017;108:995.e1-995.e4. doi:10.1016/j.wneu.2017.09.012.
Mendonça R, Lima TT, Oppitz PP, Raupp SF. Herniation of the cerebellar tonsils after suprasellar arachnoid cyst shunt: case report. Arq Neuropsiquiatr. 2006;64(2B):523-525. doi:10.1590/s0004-282x2006000300033.
Bahuleyan B, Rao A, Chacko AG, Daniel RT. Supracerebellar arachnoid cyst - A rare cause of acquired Chiari I malformation. J Clin Neurosci. 2007;14(9):895-898. doi:10.1016/j.jocn.2006.06.009
Potgieser AR, Hoving EW. A novel technique to treat acquired Chiari I malformation after supratentorial shunting. Childs Nerv Syst. 2016;32(9):1721-1725. doi:10.1007/s00381-016-3138-7.
Referanslar
Kular S, Cascella M. Chiari Malformation Type 1. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 9, 2024.
Erdoğan O, Sarıca C. Chiari Malformasyonları. Türk Nöroşirürji Dergisi. 31(1):57-63, 2021.
Doğu H, Özdemir AA. The Use of Fibrin Sealant in Chiari Malformation Type-1 Surgery; Is It Effective in Preventing the Formation of CSF Fistula? Ulutas Med J. 2019;5(1):65-70.
Atkinson JL. Resolution of tonsillar herniation after supratentorial tumor resection: case report and review of the literature. Neurosurgery. 2001;48(3):702-704. doi:10.1097/00006123-200103000-00063.
Di Rocco C, Velardi F. Acquired Chiari type I malformation managed by supratentorial cranial enlargement. Childs Nerv Syst. 2003;19(12):800-807. doi:10.1007/s00381-003-0837-7.
Wang J, Alotaibi NM, Samuel N, Ibrahim GM, Fallah A, Cusimano MD. Acquired Chiari Malformation and Syringomyelia Secondary to Space-Occupying Lesions: A Systematic Review. World Neurosurg. 2017;98:800-808.e2. doi:10.1016/j.wneu.2016.11.080.
Hajtovic S, Placantonakis DG. Resolution of Tonsillar Herniation and Syringomyelia Following Resection of a Large Anterior Frontal Parasagittal Meningioma. Cureus. 2020;12(4). doi:10.7759/cureus.7636.
Onesti ST, Ashkenazi E, Miller AM, Michelsen WJ. Resolution of acquired tonsillar herniation after resection of supratentorial meningioma. Case illustration. J Neurosurg. 1997;86(3):572. doi:10.3171/jns.1997.86.3.0572.
Sheehan JM, Jane JA Sr. Resolution of tonsillar herniation and syringomyelia after supratentorial tumor resection: case report and review of the literature. Neurosurgery. 2000;47(1):233-235. doi:10.1097/00006123-200007000-00050.
Thotakura AK, Marabathina NR. Acquired Chiari I Malformation with Syringomyelia Secondary to Colloid Cyst with Hydrocephalus - Case Report and Review of Literature. World Neurosurg. 2017;108:995.e1-995.e4. doi:10.1016/j.wneu.2017.09.012.
Mendonça R, Lima TT, Oppitz PP, Raupp SF. Herniation of the cerebellar tonsils after suprasellar arachnoid cyst shunt: case report. Arq Neuropsiquiatr. 2006;64(2B):523-525. doi:10.1590/s0004-282x2006000300033.
Bahuleyan B, Rao A, Chacko AG, Daniel RT. Supracerebellar arachnoid cyst - A rare cause of acquired Chiari I malformation. J Clin Neurosci. 2007;14(9):895-898. doi:10.1016/j.jocn.2006.06.009
Potgieser AR, Hoving EW. A novel technique to treat acquired Chiari I malformation after supratentorial shunting. Childs Nerv Syst. 2016;32(9):1721-1725. doi:10.1007/s00381-016-3138-7.
