Posterior Fossa Arachnoid Cyst Associated with Chiari I and Syringomyelia
Notice bibliographique
Résumé
The association of posterior fossa (PF) lesions with syringomyelia has been described occasionally both for solid and cystic abnormalities.Few cystic lesions of the PF have been found in association with syringomyelia, and even fewer are believed to cause cavitation of the spinal cord by descent and impaction of the cerebellar tonsils into the subarachnoid space at the level of the foramen magnum (FM).We describe a case of a PF arachnoid cyst associated with impairment of the cerebrospinal fluid (CSF) flow at the FM and syringomyelia. CASE REPORTThis 61-year-old woman had delayed developmental milestones, and never used her right arm and hand to the full extent.She reported that at an early age 'electrical treatments' were given to improve the condition of her right arm.It was predicted that she would have great difficulty with her studies, yet she obtained a university level education.In 1994 she presented with her longstanding weakness of the right arm, as well as numbness of the right side of the face extending to the ipsilateral shoulder region.The patient was managed conservatively until early 2006.At this time she complained of disagreeable sensations of her right face and right upper limb, and was noted to have 4/5 weakness of the right shoulder abductors and elbow flexors.When she came to surgical attention prior investigations had identified a 75 x 35 mm arachnoid cyst, extending from the right sigmoid sinus to the clivus, with compression and deformation of the cerebellum, IV ventricle and brain stem.There was no hydrocephalus.Crowding of the FM area was observed, but there was no overt descent of the tonsils below the FM.An 8 mm in diameter syrinx was seen from the cranio-cervical junction down to T10 (Figure 1).Two weeks before her scheduled surgery she complained of double vision and extension of the numbness down the right upper and lower limb.She was taken to the operating room and an endoscopic fenestration of the cyst was performed February 2006.Her double vision disappeared and so did the leg symptoms, but her distressing paresthesias were still present.An MR CSF flow study revealed minimal CSF flow at the FM.In June 2006 the patient underwent a right PF craniotomy for a larger fenestration of the arachnoid cyst into the cisternas of the posterior fossa.There was no significant change in her symptoms.The arachnoid cyst decreased minimally in size.Later, she reported swallowing and breathing difficulty, and it was hard for her to walk and talk simultaneously.In October 2006 a FM decompression with duroplasty was performed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,003 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».