Chiari Malformasyonunda Epidemiyoloji, Konservatif Tedaviler ve Gebelikte Hasta Yönetimi
Özet
Chiari malformasyonları (CM), serebellumun, beyin sapının ve kraniyoservikal bağlantının anatomik anomalileriyle tanımlanan, serebellumun tek başına veya alt medulla ile birlikte spinal kanala doğru aşağı doğru yer değiştirmesiyle tanımlanan heterojen bir bozukluk grubudur (1). Bu hastalığa ek olarak sirengomiyeli (SM), hidrosefali, ensefalosel veya spinal disrafizm gibi intra ve ekstrakraniyal anomaliler eşlik edebilir. CM’nin yaygınlığı halen tam olarak bilinmeyen bu hastalık asemptomatik klinikten şiddetli baş ağrısı, boyun ağrısı, baş dönmesi dengesizlik, motor ve duyu kayıpları geniş bir klinik tablo oluşturabilir (2).
CM ilk olarak 1883'te John Cleland tarafından tanımlanmıştır (3,4). 1891 ve 1894 yılında Avusturyalı Patolok Hans Chiari tarafından dört alt tipi tanımlamıştır (1,5). 1894'te, Alman Julius Arnold serebellum hernisi olan birlikte hidrosefali olmayan yeni doğanda bir miyelodisplastik bebeği rapor etmiş. Yenidoğanlarda görülen hastalığa Arnold Chiari terimi başlık olarak kullanılırken, erişkinlerde görülenlere ise Chiari malformasyonu başlığı tercih edilmektedir (5).
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