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Surgical treatment of Arnold-Chiari malformation type I in an adult patient  [PDF]
Markovi? Marko,Berisavac Iva,Bojovi? Vladimir,Kosti? Bojan
Vojnosanitetski Pregled , 2008, DOI: 10.2298/vsp0808648m
Abstract: Background. Herniation of the cerebellar tonsils through the foramen magnum into the cervical spinal canal with obliteration of the cerebellomedullary cistern is the primary feature of Arnold-Chiari type I malformation (ACM I). It is considered to be congenital malformation, although there have been reported cases of an acquired form. Case report. We presented a female patient, 45-year old, with ACM I without syringomyelia as a rare and unusual clinical image, as well as the effect of decompressive surgery in the treatment of this malformation. The patient was admitted to the Department of Neurosurgery with clinical signs of truncal ataxia worsening during the last six years. Moderate quadriparesis with predominant lower extremity involvement and the signs of the cranial nerves damages occured during the last seven months before admission, with progressive clinical course up to the date of admission. Neurosurgical treatment that included suboccipital medial craniectomy with resection of posterior arch C1 vertebrae and C2 laminectomy resulted in a significant clinical improvement and a much better quality of life. Conclusion. Posterior craniovertebral decompression with microsurgical reduction of the cerebellar tonsils and placement of an artificial dural graft is a treatment of choice in severe forms of ACM I without syringomyelia. .
Anesthesia management for pregnant patient with Arnold-Chiari malformation type I: A case report
Ahmet Kü?ük,Hasan Hüsnü Yüce,Harun Aydo?an,Mahmut Alp Karahan
Dicle Medical Journal , 2012,
Abstract: The Arnold-Chiari I malformation (ACM) is a congenitalanomaly characterized by downward herniation of thecerebellar tonsils into the spinal canal. The anomaly maypresent in a variety of ways with vague symptoms suchas head and limb pains, vertigo, hypoesthesia, weaknessin the extremities. Diagnosis is often difficult and thereforedelayed. Measurement of intracranial pressure in thesepatients is an important measure thus precautions shoulbe taken for avoidance of increased intracranial pressure.In this case report, we discussed the anesthetic managementof a pregnant patient with Arnold Chiari I malformationwho underwent an emergency caesarean section.
Selected aspects of social cognition in patient with total agenesis of the corpus callosum (ACC) and Arnold-Chiari desease – case study  [PDF]
Daniluk, Beata,Borkowska, Aneta R,Kaliszewska, Agnieszka
Psychiatria Polska , 2013,
Abstract: Aim. The goal of the research was a characteristic of emotional-social competencies and communicative abilities in a 16-years old patient with ACC and Arnold-Chiari disease and higher than average intelligence. Method. RHLB-PL was applied. Results. Total score in RHLB-PL suggested language and communication impairment. The greatest problems were observed in the field of behavioral self-control and discourse abilities. The patient had difficulties in the topic of the discourse maintaining, resisting from production of unconnected topics and comments, interject inappropriate remarks. Problems in humor comprehension and the dissociation between relative high level of written metaphors analysis abilities and low level of Picture Metaphors perception and explanation were observed. Linguistic Prosody was average. Conclusion. Patient M.J. with agenesis of corpus callosum presented high number of deficits typical in right hemisphere damage patients. It is possible to explain that fact in the context of interhemispheric transfer disorders, specially when complex material was processed.
Hemifacial spasm in a patient with neurofibromatosis and Arnold-Chiari malformation: a unique case association
Felício, Andre Carvalho;Godeiro-Junior, Clecio de Oliveira;Borges, Vanderci;Silva, Sonia Maria de Azevedo;Ferraz, Henrique Ballalai;
Arquivos de Neuro-Psiquiatria , 2007, DOI: 10.1590/S0004-282X2007000500026
Abstract: background: the association of hemifacial spasm (hfs), chiari type i malformation (cim) and neurofibromatosis type 1 (nf1) has not been described yet. case report: we report the case of a 31-year-old woman with nf1 who developed a right-sided hfs. on magnetic resonance imaging (mri) a cim was seen without syringomyelia. the patient has been successfully treated with botulinum toxin type a injections for 5 years without major side effects. conclusion:clinical features of hfs, cmi and nf1 are highlighted together with their possible relationship. also, therapeutic strategies are also discussed.
Long Latency Auditory Potential (P300) Outcomes in a Patient with Vestibular Schwannoma after Cochlear Implant Surgery  [PDF]
Maria Stella Arantes do Amaral, Victor Goiris Calderaro, Henrique Furlan Pauna, Eduardo Tanaka Massuda, Ana Cláudia Mirandola Barbosa Reis, MiguelMiguel ?ngelo Hyppolito
Case Reports in Clinical Medicine (CRCM) , 2018, DOI: 10.4236/crcm.2018.75031
Abstract: Background: Neurofibromatosis type 2 (NF2) is a rare syndrome and it is usually presented with bilateral vestibular schwannomas (VS), multiple meningiomas, and other types of tumors associated to peripheral nerves. Hearing loss is one of its leading manifestations, and surgery for removal of the tumor is often required. Cochlear implant (CI) surgery is an option for auditory rehabilitation and long latency auditory potentials (P300) are becoming a very useful tool to assess hearing outcomes. Objective: To verify the presence of P300 waves during auditory and cortical function assessment in a patient submitted to VS removal and CI surgery. Design: Retrospective chart review. Case Report: A 62 years old male patient, presented at the clinic with a bilateral severe to profound hearing loss, worst at the right side. MRI scan revealed bilateral expansive tumor within the internal auditory canal expanding to cerebellopontine angle, suggestive of VS. Tumor was removed at the right side, and CI surgery was indicated for the left ear. P300 tests were performed pre-operatively, at the moment of activation, and 6 months post-operatively. After CI activation, P300 waves appeared, and presented reduced latency and increased amplitude after 6 months of CI use. Conclusion: P300 waves appear to be dependent on the auditory stimulus to be generated, showing that it can be a useful tool to estimate improvement in cortical cognitive function after restoring hearing through CI surgery after VS removal.
ARNOLD – CHIARI MALFORMATION AND SYRINGOMYELIA  [cached]
Adnan Burina,Dzevdet Smajlovic,Osman Sinanovic,Mirjana Vidovic
Acta Medica Saliniana , 2009, DOI: 10.5457/ams.31.09
Abstract: Generally, Arnold – Chiari malformation associated with syringomyelia is not rare. In this case report we present a 52 years old female patient with a history of neck-pain, low-back pain, pain in both arms as well as frequent numbness in the lateral regions of both arms. She also experienced walk disturbance and in her previous history she reports a car accident, twenty-eight years ago. She broke windshield with her forehead, but remained conscious at the time. At the time of admittance at the Department of Neurology, her neurological status was remarkable for cerebellar symptomatology (ataxia, positive Romberg-sign, finger–nose test which she did with tremor and was not able to perform tandem-walk ), hypoestesia of the right side of the body, hyper-reflection of both arms and legs, bilaterally, more pronounced at the right side; right foot subclonus and spastic-ataxic walk. Neurological status could not be explained by previously performed tests: x-ray of cervical spine, lumbal myelography, computerized tomography (CT) of the brain. However, magnetic resonance imaging (MRI) of the brain and cervical spine verified Arnold-Chiari malformation (type I) associated with syringomyelia from C3 to C7. Patient was referred to surgery and subsequent physical rehabilitation.
Cochlear Implant
Mehrnaz Karimi
Audiology , 1992,
Abstract: People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.
Cochlear Implant
Mehrnaz Karimi
Audiology , 1993,
Abstract: People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss. In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.
Association of HTLV-I with Arnold Chiari syndrome and syringomyelia
Viana, Gra?a Maria de Castro;Diniz Neto, Jo?o Arnaud;Furtado, Igor de Sousa;Binda Júnior, José Roberto;Tanaka, Bárbara Neiva;Nascimento, Maria do Desterro Soares Brand?o;
Brazilian Journal of Infectious Diseases , 2008, DOI: 10.1590/S1413-86702008000600018
Abstract: htlv-i is associated with a broad spectrum of manifestations, including tropical spastic paraparesis and adult t-cell leukemia/lymphoma. arnold chiari syndrome is a condition characterized by herniation of the cerebellar tonsils through the foramen magnum. this condition should be suspected in all patients with headache and impaired motor coordination. syringomyelia is a developmental anomaly that leads to the formation of an intramedullary cavity. its clinical presentation is classically characterized by syringomyelic dissociation of sensation, with suspended distribution in the proximal portion of the trunk and upper limbs and preservation in other regions. we report here a case of association of the three diseases, which is rare in clinical practice, illustrating the difficulty in the diagnosis and therapeutic management of these conditions.
Síndrome de Terson en malformación de Arnold Chiari I Terson's syndrome associated with Arnold-Chiari I malformation
A Chinchurreta-Capote,P. Chinchurreta,P. Ranchal,F. Pérez
Archivos de la Sociedad Espa?ola de Oftalmología , 2007,
Abstract: Caso clínico: Se presenta una paciente con Síndrome de Terson (ST) bilateral tras descompresión quirúrgica medular como tratamiento de su malformación de Arnold Chiari tipo I. Se estudia y compara la progresión de sus hemorragias prerretinianas tras tratamiento con láser Nd:YAG en su ojo derecho y observación en el izquierdo, formándose en éste una membrana epirretiniana. Discusión: El tratamiento del ST se basa en observación y/o cirugía según ciertas pautas. La hialoidectomía YAG también consigue buenos resultados en casos seleccionados. Case report: We present a patient with bilateral Terson’s syndrome after brainstem surgical decompression as treatment for her Arnold-Chiari I malformation. We have studied and compared the progression of preretinal hemorrhage after Nd:YAG laser treatment of the right eye and observation of the left, and also the formation of an epiretinal membrane in the left eye. Discussion: Treatment of Terson’s syndrome is based on observation or surgery according to different criteria. Hyaloidectomy with YAG laser produces good results in selected cases.
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