{"id":313,"date":"2025-11-10T11:12:47","date_gmt":"2025-11-10T10:12:47","guid":{"rendered":"https:\/\/www.chu-tours.fr\/neurochirurgie\/?page_id=313"},"modified":"2026-03-18T15:42:52","modified_gmt":"2026-03-18T14:42:52","slug":"malformation-de-chiari","status":"publish","type":"page","link":"https:\/\/www.chu-tours.fr\/neurochirurgie\/autres-pathologies\/malformation-de-chiari\/","title":{"rendered":"Malformation de Chiari"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"313\" class=\"elementor elementor-313\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3409196 e-con-full e-flex e-con e-parent\" data-id=\"3409196\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9ed761e elementor-widget elementor-widget-global elementor-global-220 elementor-widget-html\" data-id=\"9ed761e\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<!-- FIL D\u2019ARIANE DYNAMIQUE - CHRU TOURS (VERSION JAVASCRIPT\/CHEVRONS) -->\r\n<div id=\"breadcrumb-js\" class=\"breadcrumb\"><\/div>\r\n\r\n<style>\r\n    .breadcrumb {\r\n        font-size: 14px;\r\n        font-family: \"Segoe UI\", sans-serif;\r\n        margin-bottom: 20px;\r\n        color: #555;\r\n        display: flex;\r\n        flex-wrap: wrap;\r\n        gap: 0.5em;\r\n        align-items: center;\r\n        background: #f4f6f8;       \/* fond gris clair (modifiable ou \u00e0 supprimer) *\/\r\n        padding: 8px 12px;\r\n        border-radius: 4px;\r\n    }\r\n\r\n    .breadcrumb a {\r\n        text-decoration: none;\r\n        color: #008c9e;            \/* couleur des liens cliquables *\/\r\n        font-weight: 600;\r\n        text-transform: capitalize;\r\n    }\r\n\r\n    .breadcrumb span {\r\n        color: #0d3182;            \/* couleur du dernier \u00e9l\u00e9ment (page active) *\/\r\n        font-weight: 600;\r\n        text-transform: capitalize;\r\n    }\r\n\r\n    .breadcrumb .separator {\r\n        font-weight: normal;\r\n        color: #888;\r\n        margin: 0 4px;\r\n    }\r\n<\/style>\r\n\r\n<script>\r\n    document.addEventListener(\"DOMContentLoaded\", function () {\r\n        const path = window.location.pathname.split(\"\/\").filter(p => p);\r\n        if (path.length === 0) return;\r\n\r\n        let html = '';\r\n        let fullPath = \"\";\r\n\r\n        path.forEach((segment, index) => {\r\n            fullPath += \"\/\" + segment;\r\n            const label = decodeURIComponent(segment.replace(\/[-_]\/g, \" \"))\r\n            .toLowerCase()\r\n            .replace(\/^\\w\/, c => c.toUpperCase());\r\n\r\n            if (index < path.length - 1) {\r\n                html += `<span class=\"separator\">\u203a<\/span><a href=\"${fullPath}\">${label}<\/a>`;\r\n            } else {\r\n                html += `<span class=\"separator\">\u203a<\/span><span>${label}<\/span>`;\r\n            }\r\n        });\r\n\r\n        const container = document.getElementById(\"breadcrumb-js\");\r\n        if (container) container.innerHTML = html;\r\n    });\r\n\r\n    \/*\r\n\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\r\n\ud83c\udfa8 ASTUCES DE PERSONNALISATION (\u00e0 modifier au besoin)\r\n\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\r\n\r\n1. Modifier la couleur du dernier niveau (page courante) :\r\n\u2192 dans le CSS : change `color: #0d3182;` dans `.breadcrumb span`\r\n\r\n2. Modifier la couleur ou le style des liens :\r\n\u2192 dans `.breadcrumb a`, tu peux ajuster :\r\n- color (ex: #0073aa)\r\n- font-weight\r\n- text-transform\r\n\r\n3. Supprimer le fond gris clair :\r\n\u2192 supprime `background: #f4f6f8;` dans `.breadcrumb`\r\n\r\n4. Centrer le fil d\u2019Ariane :\r\n\u2192 ajoute `justify-content: center;` dans `.breadcrumb`\r\n\r\n5. Changer le s\u00e9parateur :\r\n\u2192 remplace `\u203a` dans le code HTML g\u00e9n\u00e9r\u00e9 (`.separator`)\r\nPar exemple : `&raquo;` (pour \u00bb) ou `\/`\r\n\r\n6. Supprimer \"Accueil\" du d\u00e9but :\r\n\u2192 commente ou supprime : `let html = '<a href=\"\/\">Accueil<\/a>';`\r\n\r\n7. Ajouter une classe sp\u00e9cifique au dernier segment :\r\n\u2192 tu peux remplacer `<span>` par `<span class=\"current\">` et styler `.current` comme tu veux\r\n\r\n8. Forcer un affichage responsive encore plus propre :\r\n\u2192 dans `.breadcrumb`, tu peux ajouter `flex-wrap: wrap;` et g\u00e9rer les `gap` ou marges\r\n\r\n\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\r\n*\/\r\n<\/script>\r\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9d353d3 e-con-full e-flex e-con e-parent\" data-id=\"9d353d3\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c6ff247 elementor-widget__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"c6ff247\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<h2>Qu\u2019est-ce que la malformation de Chiari ?<\/h2><p style=\"text-align: justify;\">Il s\u2019agit d\u2019une malformation cong\u00e9nitale ou acquise correspondant \u00e0 une <strong>anomalie de la charni\u00e8re occipito-cervicale <\/strong>avec une descente d\u2019une partie du <strong>cervelet dans le trou occipital<\/strong> (o\u00f9 se situe habituellement uniquement le tronc c\u00e9r\u00e9bral).<\/p><p style=\"text-align: justify;\">Celle-ci est souvent associ\u00e9e \u00e0 des <strong>troubles de la circulation du liquide c\u00e9r\u00e9bro-spinal<\/strong> et peut aboutir \u00e0 une accumulation de liquide notamment au niveau m\u00e9dullaire (=<strong>syringomy\u00e9lie).<\/strong><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-425514f e-flex e-con-boxed e-con e-parent\" data-id=\"425514f\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5ba6428 elementor-widget elementor-widget-image\" data-id=\"5ba6428\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/chiari.jpg\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"chiari\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6MTM2LCJ1cmwiOiJodHRwczpcL1wvd3d3LmNodS10b3Vycy5mclwvbmV1cm9jaGlydXJnaWVcL3dwLWNvbnRlbnRcL3VwbG9hZHNcL3NpdGVzXC8xOFwvMjAyNVwvMTBcL2NoaWFyaS5qcGcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"768\" height=\"647\" src=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/chiari-768x647.jpg\" class=\"attachment-medium_large size-medium_large wp-image-136\" alt=\"malformation d\u2019Arnold-Chiari\" srcset=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/chiari-768x647.jpg 768w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/chiari-300x253.jpg 300w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/chiari.jpg 930w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5f8b091 e-con-full e-flex e-con e-parent\" data-id=\"5f8b091\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2b4d321 elementor-widget elementor-widget-image\" data-id=\"2b4d321\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"497\" height=\"499\" src=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-preop.png\" class=\"attachment-full size-full wp-image-535\" alt=\"Malformation d\u2019Arnold Chiari avec syringomy\u00e9lie, pr\u00e9op\u00e9ratoire\" srcset=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-preop.png 497w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-preop-300x300.png 300w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-preop-150x150.png 150w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-preop-40x40.png 40w\" sizes=\"(max-width: 497px) 100vw, 497px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b38754c elementor-widget elementor-widget-image\" data-id=\"b38754c\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"497\" height=\"499\" src=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-postop.png\" class=\"attachment-full size-full wp-image-534\" alt=\"Malformation d\u2019Arnold Chiari avec syringomy\u00e9lie, post op\u00e9ratoire\" srcset=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-postop.png 497w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-postop-300x300.png 300w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-postop-150x150.png 150w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2026\/02\/Chiari-postop-40x40.png 40w\" sizes=\"(max-width: 497px) 100vw, 497px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8200e22 e-flex e-con-boxed e-con e-parent\" data-id=\"8200e22\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8161e61 elementor-widget elementor-widget-text-editor\" data-id=\"8161e61\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p style=\"text-align: center;\"><em><span style=\"color: #808080;\">Pr\u00e9 et post op\u00e9ratoire, disparition de l&#8217;engagement des tonsilles c\u00e9r\u00e9belleuses et diminution de la syringomy\u00e9lie<\/span><\/em><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-eea2356 e-flex e-con-boxed e-con e-parent\" data-id=\"eea2356\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-31a8745 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"31a8745\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2 style=\"text-align: justify;\">Comment est-elle d\u00e9couverte ?<\/h2><p style=\"text-align: justify;\">La d\u00e9couverte peut \u00eatre fortuite (imagerie r\u00e9alis\u00e9e pour des sympt\u00f4mes sans rapport avec cette malformation).<\/p><p style=\"text-align: justify;\">Les sympt\u00f4mes de la malformation de Chiari peuvent \u00eatre\u00a0:<\/p><ul style=\"text-align: justify;\"><li><strong>C\u00e9phal\u00e9es,<\/strong> augment\u00e9e lors de l\u2019effort \/ la toux<\/li><li>F<strong>aiblesses <\/strong>dans les membres<\/li><li>Troubles de la<strong> sensibilit\u00e9 <\/strong>des membres (notamment absence de sensation de la temp\u00e9rature)<\/li><li>Troubles du <strong>sommeil (<\/strong>syndrome d\u2019apn\u00e9e du sommeil central).<\/li><\/ul><p style=\"text-align: justify;\">L\u2019IRM c\u00e9r\u00e9bro-m\u00e9dullaire permet le diagnostic.<\/p><p style=\"text-align: justify;\">Des examens compl\u00e9mentaires tels qu\u2019une <strong>polysomnographie <\/strong>ou une consultation en <strong>ophtalmologie<\/strong> peuvent \u00eatre n\u00e9cessaire.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3673416 e-flex e-con-boxed e-con e-parent\" data-id=\"3673416\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d9b4ea1 elementor-widget elementor-widget-text-editor\" data-id=\"d9b4ea1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2 style=\"text-align: justify;\">Quelle est la prise en charge chirurgicale ?<\/h2><p style=\"text-align: justify;\">En cas de sympt\u00f4mes invalidants en lien avec la malformation de Chiari, une prise en charge peut \u00eatre propos\u00e9.<\/p><p style=\"text-align: justify;\">Il s\u2019agit de la r\u00e9alisation d\u2019une <strong>plastie d\u2019agrandissement<\/strong> au niveau de la charni\u00e8re occipito-cervical.<\/p><p style=\"text-align: justify;\">Sous anesth\u00e9sie g\u00e9n\u00e9rale, il est r\u00e9alis\u00e9 l\u2019ablation d\u2019une partie de l\u2019os occipital +\/-\u00a0 la partie post\u00e9rieure de la premi\u00e8re vert\u00e8bre cervicale. Ensuite la dure m\u00e8re est ouverte et une plastie est r\u00e9alis\u00e9e avec apposition d\u2019un substitut.<\/p><p style=\"text-align: justify;\">La chirurgie correspond donc \u00e0 un <strong>\u00e9largissement du trou occipital<\/strong> permettant un repositionnement du cervelet et la lev\u00e9e de la compression du tronc c\u00e9r\u00e9bral. Le liquide c\u00e9r\u00e9brospinal peut \u00e9galement reprendre un \u00e9coulement classique.<\/p><p style=\"text-align: justify;\"><strong>La dur\u00e9e d\u2019hospitalisation est de 4 \u00e0 7 nuits<\/strong>\u00a0:<\/p><ul style=\"text-align: justify;\"><li>Arriv\u00e9e la veille de l\u2019intervention<\/li><li>2 nuits en unit\u00e9 de soins continus neurochirurgicale<\/li><li>1 \u00e0 3 nuits en hospitalisation compl\u00e8te<\/li><li>Puis <strong>retour \u00e0 domicile<\/strong><\/li><\/ul><h2 style=\"text-align: justify;\">Et pour la suite\u00a0?<\/h2><p style=\"text-align: justify;\">En post op\u00e9ratoire imm\u00e9diat, il est fr\u00e9quent que le patient pr\u00e9sente des naus\u00e9es, vertiges voir des vomissements. Ces sympt\u00f4mes c\u00e8dent g\u00e9n\u00e9ralement dans les premi\u00e8res jours post op\u00e9ratoires.<\/p><p style=\"text-align: justify;\">Le patient est ensuite revu par son chirurgien en <strong>consultation post-op\u00e9ratoire<\/strong> avec une imagerie de contr\u00f4le.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Qu\u2019est-ce que la malformation de Chiari ? Il s\u2019agit d\u2019une malformation cong\u00e9nitale ou acquise correspondant \u00e0 une anomalie de la charni\u00e8re occipito-cervicale avec une descente d\u2019une partie du cervelet dans le trou occipital (o\u00f9 se situe habituellement uniquement le tronc c\u00e9r\u00e9bral). Celle-ci est souvent associ\u00e9e \u00e0 des troubles de la circulation du liquide c\u00e9r\u00e9bro-spinal et [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":289,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"publishpress_future_action":{"enabled":false,"date":"2026-04-26 20:57:41","action":"change-status","newStatus":"draft","terms":[],"taxonomy":""},"_links":{"self":[{"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages\/313"}],"collection":[{"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/comments?post=313"}],"version-history":[{"count":16,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages\/313\/revisions"}],"predecessor-version":[{"id":618,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages\/313\/revisions\/618"}],"up":[{"embeddable":true,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages\/289"}],"wp:attachment":[{"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/media?parent=313"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}