Chiari Malformations: Diagnosis, Treatments and Failures-Kenan Arnautovic, MD, PhD, FAANS, FACS Video

Video Transcription

Video Summary

The video presentation discusses adult KR1 malformation, specifically its demographics, the anatomy of the craniocervical junction, and the results of microsurgical decompression. KR1 malformation is a congenital or acquired hindbrain deformity, first described by Dr. Chiari in 1891. It involves the caudal displacement of posterior fossa structures below the foramen magnum. It is associated with tonsil elongation and may be related to syringomyelia or hydrocephalus. The average age of presentation is 41, and prevalence ranges between 0.5% and 1%. The malformation causes impairment of spinal fluid circulation at the cranio-cervical junction, leading to obstruction and pressure transmission issues. The exact etiology is unknown, but there are embryological defects in the development of the occipital bone. Syringomyelia is commonly associated with KR1 malformation but can also occur due to other conditions. The video also discusses the association between KR1 malformation and increased body mass index (BMI), as weight gain can worsen symptoms and weight loss can improve them. The video describes the surgical technique of decompression, including bone removal, dural opening, arachnoid opening, and tonsillar resection. The outcomes of decompression surgery for KR1 malformation are generally positive, with improvements in headache symptoms, syringomyelia, and neurological deficits. Complications and mortality are rare but can include pseudomeningocele, aseptic meningitis, and respiratory-related issues. Overall, the video provides an informative overview of adult KR1 malformation and its surgical management. No specific credits were mentioned in the transcript.

Keywords

adult KR1 malformation

cranio-cervical junction

syringomyelia

decompression surgery

headache symptoms

neurological deficits

surgical management