Serdar KABATAŞ, Tufan CANSEVER, Cem YILMAZ, Aykan AKAR, ERDİNÇ CİVELEK, Nur ALTINÖRS

Symptomatic chiari malformation with syringomyelia after cervical trauma: Case report

Chiari Malformasyonu Tip I (CM-I), serebellar tonsillerin foramen magnumdan fıtıklaşması ve genlde sirengomyelinin eşlik ettiği konjenital hastalıktır. Servikal travma gibi tetikleyen bir durum olmadığı sürece belirti vermeyebilir. Trafik kazası sonrası boyun ağrısından şikayet eden bir 54 yaşında erkek hasta sunuldu. Üst ekstremitelerinde hafif parezisi vardı. Nöroradyolojik incelemelerinde C6-7 faset ve C7 lamina fraktürü; C1 seviyesinden T3 seviyesine kadar uzanan sirengomyelik kavite ve CM-1 tespit edildi. Travma sonrası erken dönemde parezisi artan hastaya foramen magnum dekompresyonu ve posterior servikal stabilizasyon uygulandı. Hastanın parezisinin gerilediği ve izlem manyetik rezonans incelemelerinde sirenks çapında küçülme olduğu tespit edildi. Belirti vermeyen CM-1 hastalarının travma sonrası belirti verebileceği akılda tutulmalıdır.

Servikal travma sonrası belirti veren chiari malformasyonu: Olgu sunumu

Chiari malformation type-I (CM-I) is a congenital disorder characterized by downward displacement of the cerebellar tonsils thru the foramen magnum, with/ without syringomyelia. The patients can be asymptomatic until an aggravation condition like cervical trauma occurs. We present a 54 years old male patient suffering from neck pain after traffic accident. He had mild motor weakness in upper extremities. His neuroradiological examinations revealed C6-7 facet and C7 lamina fractures; syringomyelia descending from C1 to T3 and a CM-I. In early post-traumatic follow-up period, his weakness was progressed, foramen magnum decompression and posterior cervical stabilization was performed. His motor weakness recovered and follow-up magnetic resonance imaging (MRI) examination showed an evident regression of syrinx diameter. It should be kept in mind that previously asymptomatic CM-1 patients can become symptomatic after cervical trauma.

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