Diagnosis and treatment of Chiari malformation type 1 in children : the International Consensus Document
Massimi, Luca (Fondazione Policlinico Universitario A. Gemelli IRCCS)
Peretta, Paola (AOU Citta' della Salute e della Scienza di Torino)
Erbetta, Alessandra (Fondazione IRCCS Istituto Neurologico Carlo Besta)
Solari, Alessandra (Fondazione IRCCS Istituto Neurologico Carlo Besta)
Farinotti, Mariangela (Fondazione IRCCS Istituto Neurologico Carlo Besta)
Ciaramitaro, Palma (AOU Citta' della Salute e della Scienza di Torino)
Saletti, Veronica (Fondazione IRCCS Istituto Neurologico Carlo Besta)
Caldarelli, Massimo (Fondazione Policlinico Universitario A. Gemelli IRCCS)
Canheu, Alexandre Casagrande (Universidade Estadual de Londrina)
Celada, Carlo ("Associazione Italiana Siringomielia e Arnold Chiari", Garino)
Chiapparini, Luisa (Fondazione IRCCS Istituto Neurologico Carlo Besta)
Chieffo, Daniela (Fondazione Policlinico Universitario A Gemelli IRCCS and UCSC)
Cinalli, Giuseppe (Santobono-Pausilipon Children's Hospital)
Di Rocco, Federico (Université de Lyon)
Furlanetto, Marika (Fondazione IRCCS Istituto Neurologico Carlo Besta)
Giordano, Flavio (Meyer Pediatric Hospital, Florence)
Jallo, George (Johns Hopkins All Children's Hospital)
James, Syril (Necker Enfants Malades Hospital)
Lanteri, Paola (Fondazione IRCCS Istituto Neurologico Carlo Besta)
Lemarchand, Christian (Conseil Scientifique APAISER S&C, Treillières, France)
Messing-Jünger, Martina (Asklepios Kinderklinik)
Parazzini, Cecilia (Children Hospital V. Buzzi)
Paternoster, Giovanna (Necker Enfants Malades Hospital)
Piatelli, Gianluca (Gaslini Children's Hospital)
Poca Pastor, María Antonia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Prabahkar, Prab (Great Ormond Street Hospital for Children (Londres))
Ricci, Federica (AOU Citta' della Salute e della Scienza di Torino)
Righini, Andrea (Children Hospital V. Buzzi)
Sala, Francesco (Great Ormond Street Hospital for Children (Londres))
Sahuquillo Barris, Juan (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Stoodley, Marcus (Macquarie University Clinical Associates)
Talamonti, Giuseppe (ASST Niguarda)
Thompson, Dominic (Great Ormond Street Hospital for Children (Londres))
Triulzi, Fabio (University of Milan)
Zucchelli, Mino (IRCCS Istituto delle Scienze Neurologiche di Bologna)
Valentini, Laura (Fondazione IRCCS Istituto Neurologico Carlo Besta)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	Chiari malformation type 1 (CM1) is a rare condition where agreed classification and treatment are still missing. The goal of this study is to achieve a consensus on the diagnosis and treatment of CM1 in children. A multidisciplinary panel formulated 57 provisional statements based on a review of the literature. Thirty-four international experts (IE) participated in a Delphi study by independently rating each statement on a 4-point Likert scale ("strongly disagree," "disagree," "agree," "strongly agree"). Statements that were endorsed ("agree" or "strongly agree") by < 75% of raters were re-formulated, or new statements were added, and another Delphi round followed (up to a maximum of three). Thirty-five IE were contacted and 34 agreed to participate. A consensus was reached on 30/57 statements (52. 6%) after round 1. Three statements were added, and one removed. After round 2, agreement was reached on 56/59 statements (94. 9%). Finally, after round 3, which took place during the 2019 Chiari Consensus Conference (Milan, Italy), agreement was reached on 58/59 statements (98. 3%) about four main sections (Definition and Classification, Planning, Surgery, Isolated Syringomyelia). Only one statement did not gain a consensus, which is the "definition of radiological failure 24 month post-surgery. " The consensus document consists of 58 statements (24 on diagnosis, 34 on treatment), serving clinicians and researchers following children with CM1. There is a clear need for establishing an international network and registry and to promote collaborative studies to increase the evidence base and optimize the long-term care of this patient population.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Chiari 1 malformation ; Syringomyelia ; Consensus ; Children ; Craniovertebral decompression ; Management
Published in:	Neurological Sciences, Vol. 43 (june 2021) , p. 1311-1326, ISSN 1590-3478

DOI: 10.1007/s10072-021-05317-9
PMID: 34097175

16 p, 898.0 KB

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