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- Title
Diagnosis and treatment of Chiari malformation and syringomyelia in adults: international consensus document.
- Authors
Ciaramitaro, Palma; Massimi, Luca; Bertuccio, Alessandro; Solari, Alessandra; Farinotti, Mariangela; Peretta, Paola; Saletti, Veronica; Chiapparini, Luisa; Barbanera, Andrea; Garbossa, Diego; Bolognese, Paolo; Brodbelt, Andrew; Celada, Carlo; Cocito, Dario; Curone, Marcella; Devigili, Grazia; Erbetta, Alessandra; Ferraris, Marilena; Furlanetto, Marika; Gilanton, Mado
- Abstract
Background: Syringomyelia and Chiari malformation are classified as rare diseases on Orphanet, but international guidelines on diagnostic criteria and case definition are missing. Aim of the study: to reach a consensus among international experts on controversial issues in diagnosis and treatment of Chiari 1 malformation and syringomyelia in adults. Methods: A multidisciplinary panel of the Chiari and Syringomyelia Consortium (4 neurosurgeons, 2 neurologists, 1 neuroradiologist, 1 pediatric neurologist) appointed an international Jury of experts to elaborate a consensus document. After an evidence-based review and further discussions, 63 draft statements grouped in 4 domains (definition and classification/planning/surgery/isolated syringomyelia) were formulated. A Jury of 32 experts in the field of diagnosis and treatment of Chiari and syringomyelia and patient representatives were invited to take part in a three-round Delphi process. The Jury received a structured questionnaire containing the 63 statements, each to be voted on a 4-point Likert-type scale and commented. Statements with agreement <75% were revised and entered round 2. Round 3 was face-to-face, during the Chiari Consensus Conference (Milan, November 2019). Results: Thirty-one out of 32 Jury members (6 neurologists, 4 neuroradiologists, 19 neurosurgeons, and 2 patient association representatives) participated in the consensus. After round 2, a consensus was reached on 57/63 statements (90.5%). The six difficult statements were revised and voted in round 3, and the whole set of statements was further discussed and approved. Conclusions: The consensus document consists of 63 statements which benefited from expert discussion and fine-tuning, serving clinicians and researchers following adults with Chiari and syringomyelia.
- Publication
Neurological Sciences, 2022, Vol 43, Issue 2, p1327
- ISSN
1590-1874
- Publication type
Article
- DOI
10.1007/s10072-021-05347-3