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目的探讨脑脊液动力学在Ｃｈｉａｒｉ畸形伴脊髓空洞症的发生、发展中的作用，提出本病脑脊液动力学异常的早期指标及相应的手术治疗方法。方法全组２２例病人经ＭＲＩ和ＣＴ检查，伴脑积水者进行颅内压监护，其他患者行颈部不同体位的术前和术后的脑脊液动力学研究，按其异常程度分别行脑室腹腔分流术、后颅＋颈１－２椎板减压术和硬膜减张。结果全部病人均有不同程度的脑脊液动力学的改善，术后１６例获得随访，其中１２例复查ＭＲＩ，空洞缩小９例，３例同术前。３例临床症状完全缓解，９例有不同程度改善，２例同术前，２例加重。结论脑脊液动力学的异常在Ｃｈｉａｒｉ畸形伴脊髓空洞症的发病和病程演变中有重要意义，而纠正其异常应是手术治疗的主要目的。合并颅内压增高者，脑室腹腔分流术同样可使空洞缩小。
Objective To investigate the role of cerebrospinal fluid dynamics in the occurrence and development of Chiari malformation associated with syringomyelia and to propose early indicators of cerebrospinal fluid dynamics and the corresponding surgical treatment. Methods The whole group of 22 patients underwent MRI and CT examination with intracranial pressure monitoring in patients with hydrocephalus. The other patients underwent preoperative and postoperative cerebrospinal fluid dynamics of different positions in the neck. According to their abnormalities, Shunt, posterior cranial + cervical 1-2 laminar decompression and dural decompression. Results All patients had different degrees of cerebrospinal fluid dynamics improvement. After the operation, 16 patients were followed up. Among them, 12 patients underwent MRI examination, 9 patients had empty cavity reduction and 3 patients had the same preoperative operation. 3 cases of complete remission of clinical symptoms, 9 cases improved to varying degrees, 2 cases with preoperative, 2 cases worsened. Conclusions The abnormalities of cerebrospinal fluid dynamics are important in the pathogenesis and progression of Chiari malformation associated with syringomyelia. To correct the abnormalities should be the main purpose of surgical treatment. Merger of increased intracranial pressure, ventriculoperitoneal shunt can also make the cavity shrink.