Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Case Reports Comparative Study
Acquired Chiari type I malformation managed by supratentorial cranial enlargement.
Acquired Chiari type-I malformation in hydrocephalic patients who have undergone surgical treatment was initially thought to depend on a craniocephalic disproportion induced by the cerebrospinal (CSF) shunt. However, most of the reports in the literature deal with children with lumbo-peritoneal shunts and emphasize the pathogenic role of the cranio-spinal pressure differential across the foramen magnum brought about by this type of shunt. ⋯ These results, together with the observation of the concomitant upward and downward herniation of the cerebellum in both patients, indicate that secondary craniocephalic disproportion plays a relevant role in the genesis of acquired Chiari type-I malformation in children bearing extrathecal CSF shunts.