{"id":151363,"date":"2026-09-23T07:25:34","date_gmt":"2026-09-23T05:25:34","guid":{"rendered":"https:\/\/institutchiaribcn.com\/?post_type=comunicacion&p=151363"},"modified":"2026-09-23T11:06:59","modified_gmt":"2026-09-23T09:06:59","slug":"evolution-sindrome-arnold-chiari-siringomielia","status":"publish","type":"comunicacion","link":"https:\/\/institutchiaribcn.com\/fr\/evolution-sindrome-arnold-chiari-siringomielia\/","title":{"rendered":"\u00c9volution postop\u00e9ratoire favorable \u00e0 9 ans chez une patiente p\u00e9diatrique atteinte d\u2019un syndrome d\u2019Arnold-Chiari de type I et d\u2019une syringomy\u00e9lie idiopathique apr\u00e8s application du Filum System\u00ae<\/sup>"},"content":{"rendered":"

Cas clinique 18155<\/strong><\/h2>\n

Syndrome Neuro-Cr\u00e2nio-Vert\u00e9bral. Maladie du Filum. Descente des amygdales c\u00e9r\u00e9belleuses (DAC). Syndrome d\u2019Arnold-Chiari de type I. Syringomy\u00e9lie idiopathique. R\u00e9tropulsion odonto\u00efdienne (RTO). Discopathie multiple. Patiente op\u00e9r\u00e9e par section du Filum Terminale.<\/strong>
\nSection du Filum Terminale :<\/strong> 21\/02\/2017
\n\u00c2ge au moment de l\u2019intervention :<\/strong> 11 ans
\nDate du contr\u00f4le postop\u00e9ratoire :<\/strong> 24\/07\/2026<\/p>\n

\u00c2ge lors du contr\u00f4le :<\/strong> 21 ans<\/p>\n

\u00c9volution clinique apr\u00e8s 9 ans de suivi<\/strong><\/h2>\n

La patiente, qui ne souhaite pas r\u00e9v\u00e9ler son identit\u00e9, a \u00e9t\u00e9 op\u00e9r\u00e9e par le biais du Filum System\u00ae<\/strong> par l\u2019\u00e9quipe du Dr Royo \u00e0 l\u2019\u00e2ge de 11 ans. Neuf ans apr\u00e8s l\u2019intervention, elle est revenue pour un contr\u00f4le afin d\u2019\u00e9valuer son \u00e9volution clinique et radiologique \u00e0 long terme.<\/p>\n

Avant le traitement, elle pr\u00e9sentait un tableau symptomatique caract\u00e9ris\u00e9 par des c\u00e9phal\u00e9es d\u2019intensit\u00e9 variable<\/strong>, li\u00e9es aux efforts physiques et aux man\u0153uvres de Valsalva. Les c\u00e9phal\u00e9es \u00e9taient fr\u00e9quentes et se localisaient principalement dans les r\u00e9gions occipitale et frontale, accompagn\u00e9es de naus\u00e9es, de photophobie, de phonophobie et de troubles de la m\u00e9moire ant\u00e9rograde.<\/p>\n

Elle signalait \u00e9galement des douleurs aux \u00e9paules apr\u00e8s des efforts physiques<\/strong>, une sensation occasionnelle de faiblesse globale des membres sup\u00e9rieurs et des douleurs dans la r\u00e9gion inguinale gauche li\u00e9es \u00e0 la marche. Elle pr\u00e9sentait \u00e9galement des \u00e9pisodes soudains de perte de force d\u2019un membre inf\u00e9rieur ainsi que des \u00e9pisodes de sensation de chaleur au niveau des mains et des pieds, accompagn\u00e9s d\u2019une sensation de gonflement et de prurit au cours des derniers mois pr\u00e9c\u00e9dant l\u2019intervention.<\/p>\n

Apr\u00e8s plusieurs contr\u00f4les r\u00e9alis\u00e9s au cours des premi\u00e8res ann\u00e9es postop\u00e9ratoires, au cours desquels certaines fluctuations des sympt\u00f4mes ont \u00e9t\u00e9 observ\u00e9es, l\u2019\u00e9volution clinique \u00e0 long terme s\u2019est r\u00e9v\u00e9l\u00e9e favorable. Actuellement, la jeune femme d\u00e9clare que ses sympt\u00f4mes ont consid\u00e9rablement diminu\u00e9 et que certains ont m\u00eame disparu depuis plusieurs ann\u00e9es<\/strong>.<\/p>\n

Am\u00e9lioration des signes neurologiques<\/strong><\/h2>\n

Lors de l\u2019examen neurologique r\u00e9alis\u00e9 au cours du contr\u00f4le, le sp\u00e9cialiste constate une r\u00e9cup\u00e9ration compl\u00e8te ou partielle de la majorit\u00e9 des signes objectifs<\/strong> qui \u00e9taient pr\u00e9c\u00e9demment pr\u00e9sents.<\/p>\n

On observe notamment une am\u00e9lioration du nystagmus, des man\u0153uvres de Mingazzini et de Barr\u00e9 au niveau des membres inf\u00e9rieurs, ainsi que des r\u00e9flexes ost\u00e9o-tendineux, plantaires et abdominaux.<\/p>\n

Imagerie par R\u00e9sonance Magn\u00e9tique avant et apr\u00e8s l\u2019intervention<\/strong><\/h2>\n

Les images d\u2019Imagerie par R\u00e9sonance Magn\u00e9tique (IRM) pr\u00e9op\u00e9ratoires de 2016<\/strong>, r\u00e9alis\u00e9es avant la section du Filum Terminale, montraient diff\u00e9rents \u00e9l\u00e9ments en lien avec le tableau clinique de la patiente (Fig. 1 et Fig. 2).<\/p>\n

Parmi les principaux \u00e9l\u00e9ments observ\u00e9s :<\/p>\n

    \n
  • Rectification de la lordose cervicale et cyphose dorsale.<\/li>\n
  • Descente des amygdales c\u00e9r\u00e9belleuses<\/strong>, qui atteignaient jusqu\u2019\u00e0 la moiti\u00e9 du bord inf\u00e9rieur de l\u2019arc post\u00e9rieur de C1 et le bord sup\u00e9rieur de l\u2019arc post\u00e9rieur de C2.<\/li>\n
  • R\u00e9tropulsion odonto\u00efdienne.<\/li>\n
  • Discopathies aux niveaux C3-C4, C4-C5, C5-C6, C6-C7 et D8-D9.<\/li>\n
  • Syringomy\u00e9lie (SM) en C2<\/strong>, associ\u00e9e \u00e0 des signes d\u2019isch\u00e9mie et d\u2019\u0153d\u00e8me cervicaux et dorsaux, visibles jusqu\u2019\u00e0 D10.<\/strong><\/li>\n<\/ul>\n

    \"Descenso<\/p>\n

    Fig. 1. IRM cr\u00e2nio-cervicales du cas 18155 : images pr\u00e9op\u00e9ratoires de 2016 compar\u00e9es aux images postop\u00e9ratoires de 2026. La descente des amygdales c\u00e9r\u00e9belleuses et leur ascension ult\u00e9rieure sont mises en \u00e9vidence.<\/em><\/p>\n

    \"Cavidad<\/p>\n

    Fig. 2. IRM cr\u00e2nio-cervicales et dorsales du cas 18155 : images pr\u00e9op\u00e9ratoires de 2016 compar\u00e9es aux images postop\u00e9ratoires de 2026. La cavit\u00e9 syringomy\u00e9lique en C2 et sa disparition lors du contr\u00f4le postop\u00e9ratoire sont mises en \u00e9vidence.<\/em><\/p>\n

    Contr\u00f4le radiologique \u00e0 9 ans de la section du Filum Terminale<\/strong><\/h2>\n

    Sur les images d\u2019Imagerie par R\u00e9sonance Magn\u00e9tique r\u00e9alis\u00e9es en 2026, neuf ans apr\u00e8s la section du Filum Terminale selon le Filum System\u00ae<\/strong>, des modifications sont observ\u00e9es par rapport aux images pr\u00e9op\u00e9ratoires.<\/p>\n

    Les principaux \u00e9l\u00e9ments observ\u00e9s sont :<\/p>\n

      \n
    • Disparition de la syringomy\u00e9lie.<\/strong><\/li>\n
    • Ascension des amygdales c\u00e9r\u00e9belleuses.<\/strong><\/li>\n
    • Le reste des \u00e9l\u00e9ments observ\u00e9s demeure sans modification significative par rapport aux images pr\u00e9op\u00e9ratoires<\/strong>.<\/li>\n<\/ul>\n

      La comparaison des images d\u2019Imagerie par R\u00e9sonance Magn\u00e9tique permet d\u2019observer l\u2019\u00e9volution radiologique de la descente des amygdales c\u00e9r\u00e9belleuses et de la cavit\u00e9 syringomy\u00e9lique<\/strong> au cours des neuf ann\u00e9es de suivi.<\/p>\n

      \u00c9valuation de la patiente concernant le r\u00e9sultat du traitement<\/strong><\/h2>\n

      Dans son \u00e9valuation subjective des r\u00e9sultats obtenus, la jeune patiente rapporte une am\u00e9lioration de 80 % de ses sympt\u00f4mes<\/strong> et consid\u00e8re que l\u2019intervention lui a \u00e9t\u00e9 tr\u00e8s utile.<\/p>\n

      Elle indique \u00e9galement qu\u2019elle choisirait \u00e0 nouveau de subir l\u2019intervention<\/strong>, d\u00e9cision qui avait \u00e9t\u00e9 prise \u00e0 l\u2019\u00e9poque par ses parents, et affirme qu\u2019elle recommande le Filum System\u00ae<\/strong>.<\/p>\n

      \u00c9volution favorable \u00e0 long terme<\/strong><\/h2>\n

      L\u2019\u00e9volution de ce cas clinique montre une am\u00e9lioration clinique et radiologique maintenue pendant neuf ann\u00e9es de suivi<\/strong> apr\u00e8s l\u2019application du Filum System\u00ae chez une patiente op\u00e9r\u00e9e durant l\u2019enfance.<\/p>\n

      Lors du contr\u00f4le r\u00e9alis\u00e9 \u00e0 l\u2019\u00e2ge de 21 ans, on observe une diminution importante de la symptomatologie, une r\u00e9cup\u00e9ration compl\u00e8te ou partielle de plusieurs signes neurologiques objectifs ainsi que des modifications sur les images d\u2019Imagerie par R\u00e9sonance Magn\u00e9tique, notamment l\u2019ascension des amygdales c\u00e9r\u00e9belleuses et la disparition de la cavit\u00e9 syringomy\u00e9lique<\/strong> d\u00e9crite avant l\u2019intervention.<\/p>\n

      Ce cas constitue un exemple de l\u2019\u00e9volution \u00e0 long terme observ\u00e9e chez une patiente p\u00e9diatrique atteinte d\u2019un syndrome d\u2019Arnold-Chiari de type I et d\u2019une syringomy\u00e9lie idiopathique<\/strong> apr\u00e8s l\u2019application du Filum System\u00ae<\/strong>, avec une \u00e9valuation subjective favorable des r\u00e9sultats et une am\u00e9lioration rapport\u00e9e de sa qualit\u00e9 de vie.<\/strong><\/p>\n","protected":false},"featured_media":151342,"template":"","tipos-de-comunicacion":[510],"class_list":["post-151363","comunicacion","type-comunicacion","status-publish","has-post-thumbnail","hentry","tipos-de-comunicacion-nouvelles"],"yoast_head":"\nSyndrome d'Arnold-Chiari I et siringomi\u00e9lie\u00a0: \u00e9volution \u00e0 9 ans<\/title>\n<meta name=\"description\" content=\"Cas clinique d'un patient p\u00e9diatrique atteint du syndrome d'Arnold-Chiari I et de la siringomi\u00e9lie\u00a0: \u00e9volution clinique et radiologique ...\" 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