UNASSIGNED: OBJECT The natural and surgical history of @entity1645 ( @entity1645 ) in pediatric @entity1 is currently not well described. In this study the authors discuss the clinical and radiological presentation and outcomes in a large cohort of pediatric @entity1645 @entity1 treated with either conservative or surgical management. METHODS The authors retrospectively reviewed 95 cases involving pediatric @entity1 with @entity1645 who presented between 2004 and 2013. The @entity1 ranged in age from 9 months to 18 years (mean 8 years) at presentation. The cohort was evenly split between the sexes. Twenty-five @entity1 underwent @entity6804 ( @entity6804 ) with either dural splitting or duraplasty. Seventy @entity1 were managed without surgery. @entity1 were followed radiologically (mean 44.8 months, range 1.2-196.6 months) and clinically (mean 66.3 months, range 1.2-106.5 months). RESULTS Seventy @entity1 were treated conservatively and followed with serial outpatient neurological and radiological examinations, whereas 25 @entity1 were treated with @entity6804 . Of these 25 surgical @entity1 , 11 were treated with duraplasty (complete dural opening) and 14 were treated with a dura-splitting technique (incomplete dural opening). Surgical intervention was associated with better clinical resolution of symptoms and radiological resolution of @entity5326 and @entity1644 (p = 0.0392). Over the course of follow-up, 20 (41.7%) of 48 nonsurgical @entity1 who were symptomatic at presentation experienced improvement in symptoms and 18 (75%) of 24 symptomatic surgical @entity1 showed clinical improvement (p = 0.0117). There was no statistically significant difference in resolution of symptoms between duraplasty and dura-splitting techniques (p = 0.3572) or between @entity1 who underwent tonsillectomy and tonsillopexy (p = 0.1667). Neither of the 2 @entity1 in the conservative group with syrinx at presentation showed radiological evidence of resolution of the syrinx, whereas 14 (87.5%) of 16 @entity1 treated with surgery showed improvement or complete resolution of @entity1644 (p = 0.0392). In the nonsurgical cohort, 3 @entity1 (4.3%) developed new or increased syrinx. CONCLUSIONS The overwhelming majority of @entity1645 @entity1 (92.9%) managed conservatively do not experience clinical or radiological progression, and a sizeable minority (41.7%) of those who present with symptoms improve. However, appropriately selected symptomatic @entity1 (sleep @entity386 and @entity1282 ) and those presenting with @entity1644 should be considered surgical candidates because of the high rates of clinical (75%) and radiological improvement (87.5%).

Natural and surgical history of XXXX in the pediatric population.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity6804 :: ('MESH:D015192', 'Disease') :: ['posterior fossa decompression', 'PFD'] @entity1644 :: ('MESH:D013595', 'Disease') :: ['syringomyelia'] @entity1645 :: ('MESH:D001139', 'Disease') :: ['Chiari malformation Type I', 'CM-I'] @entity1282 :: ('MESH:D003680', 'Disease') :: ['dysphagia'] @entity5326 :: ('MESH:D014067', 'Disease') :: ['tonsillar ectopia'] @entity386 :: ('MESH:D001049', 'Disease') :: ['apnea']
@entity1645 :: (MESH:D001139,Disease) :: ['Chiari malformation Type I']
