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JOURNAL ARTICLE
N F Belachew, W Almiri, R Encinas, A Hakim, S Baschung, J Kaesmacher, T Dobrocky, C J Schankin, M Abegg, E I Piechowiak, A Raabe, J Gralla, P Mordasini
BACKGROUND AND PURPOSE: The correlation between imaging findings and clinical status in patients with idiopathic intracranial hypertension is unclear. We aimed to examine the evolution of idiopathic intracranial hypertension-related MR imaging findings in patients treated with venous sinus stent placement. MATERIALS AND METHODS: Thirteen patients with idiopathic intracranial hypertension (median age, 26.9 years) were assessed for changes in the CSF opening pressure, transstenotic pressure gradient, and symptoms after venous sinus stent placement...
November 2021: AJNR. American Journal of Neuroradiology
#22
JOURNAL ARTICLE
Anas Abdallah, İrfan Çınar, Betül Güler Abdallah
OBJECTIVE: Syringomyelia is a common condition seen in patients with Chiari type-I malformation (CM1). The purpose of this retrospective study was to evaluate the long-term clinical and radiological outcomes of posterior fossa decompression with duraplasty (PFDD) with coagulation of tonsillar ectopia in consecutive surgically treated adult patients with CM1-related syringomyelia (CRS). METHODS: Over 9 years' duration (1993-2001), medical charts of diagnosed patient with CM1 at our neurosurgical center were reviewed retrospectively...
April 2022: Neurological Research
#23
JOURNAL ARTICLE
John K Chae, Arsalan Haghdel, Alexander Kelly, Amanda Cruz, Myles Wood, Grant Luhmann, Jeffrey P Greenfield
BACKGROUND: Radiographic characterization of Chiari malformation (CM) has historically focused on caudal tonsillar herniation (CH) below the foramen magnum. Previously, we published evidence linking ventral tonsillar herniation (VH) and medullary symptoms in very young children. We sought to extend that investigation by studying the radiographic and clinical significance of VH in adults diagnosed with CM. METHODS: We retrospectively reviewed adults with cerebellar ectopia who underwent posterior fossa decompression with or without duraplasty (PFD/D) at our institution...
August 26, 2021: World Neurosurgery
#24
JOURNAL ARTICLE
Emily M Witsberger, John Huston, Jeremy K Cutsforth-Gregory, Patrick W Johnson, M Tariq Bhatti, John J Chen
BACKGROUND: The Mayo Clinic Study of Aging (MCSA) is a unique prospective study that systematically evaluates the normal aging population and includes many participants undergoing both MRI and lumbar puncture (LP). Using MCSA date, we aimed to determine the prevalence of indirect signs of raised intracranial pressure (ICP) on MRI and whether these correlate with LP opening pressure (OP). This is a large-scale study that evaluates how often indirect signs of increased ICP occur in a normal population...
March 1, 2022: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
#25
JOURNAL ARTICLE
Yoshikuni Kotaki, Gohsuke Hattori, Hisaaki Uchikado, Satoru Komaki, Nobuyuki Takeshige, Takahiro Miyahara, Yu Hasegawa, Motohiro Morioka
As headache is known as one of the most common symptoms in the patients with Chiari malformation type 1 (CM1), it is difficult to find out CM1-related headache among the symptoms because headache itself is commonly seen. Herein, we retrospectively review the cases of six CM1 patients complaining only of headache by which they complained of deterioration in daily life activities. The symptom of headache worsened during anteflexion (n = 2; 33%), retroflexion (n = 1; 17%), jumping (n = 3; 50%), going up the stairs (n = 1; 17%), and running (n = 1; 17%)...
July 27, 2021: Neurologia Medico-chirurgica
#26
JOURNAL ARTICLE
Blaise Simplice Talla Nwotchouang, Alaaddin Ibrahimy, Dorothy M Loth, Edward Labuda, Nicholas Labuda, Maggie Eppleheimer, Richard Labuda, Jayapalli Rajiv Bapuraj, Philip A Allen, Petra Klinge, Francis Loth
PURPOSE: Incidental cerebellar tonsillar ectopia (ICTE) that meets the radiographic criterion for Chiari malformation type I (CMI) is an increasingly common finding in the clinical setting, but its significance is unclear. The present study examined posterior cranial fossa (PCF) morphometrics and a broad range of health instruments of pediatric ICTE cases and matched controls extracted from the Adolescent Brain Cognitive Development (ABCD) dataset. METHODS: One-hundred-six subjects with ICTE and 106 matched controls without ICTE were identified from 11,411 anatomical MRI of healthy screened pediatric subjects from the ABCD project...
July 11, 2021: Neuroradiology
#27
JOURNAL ARTICLE
Lukasz Antkowiak, Marta Rogalska, Piotr Stogowski, Karolina Anuszkiewicz, Marek Mandera
BACKGROUND: Diffusion tensor imaging (DTI) application in Chiari malformation type I (CMI) is still poorly defined. This study aimed to systematically review the literature and propose perspectives toward the clinical application of DTI in CMI. METHODS: PubMed and Embase were searched for English-language articles published until October 20, 2020. Clinical studies and case series, evaluating fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), or radial diffusivity values in patients with CMI, were included...
August 2021: World Neurosurgery
#28
JOURNAL ARTICLE
A Selfa, B Ros, S Iglesias, F Ruiz, A Pérez, M A Arráez
Intracranial hypertension may be idiopathic or due to multiple etiologies. Some bone dysplasias and chronic shunt overdrainage syndrome may sometimes lead to intracranial hypertension associated with craniocerebral disproportion due to thickening of cranial diploe. The internal cranial expansion procedure has been used for patients with intracranial hypertension, whether or not associated with craniocerebral disproportion. Its purpose is to increase the intracranial volume by drilling down the inner table. This technique enables the craniocerebral disproportion to be improved and intracranial hypertension reduced...
February 2022: Neurosurgical Review
#29
JOURNAL ARTICLE
Eric A Goethe, Melissa LoPresti, Brandon Bertot, Sandi Lam
The diagnostic evaluation and role of neurosurgery in the treatment of cerebellitis is unclear. We explore the diagnostic evaluation and subsequent role of neurosurgical intervention in pediatric cerebellitis in a case series, highlighting the diagnostic work up and treatments applied. A retrospective review was conducted of all pediatricpatients diagnosed with cerebellitis for whom neurosurgery was consulted at a single center from June 2008 to February 2019. Nine patients, four males (44.4%) and five females (55...
March 2021: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
#30
JOURNAL ARTICLE
Alexander T Yahanda, P David Adelson, S Hassan A Akbari, Gregory W Albert, Philipp R Aldana, Tord D Alden, Richard C E Anderson, David F Bauer, Tammy Bethel-Anderson, Douglas L Brockmeyer, Joshua J Chern, Daniel E Couture, David J Daniels, Brian J Dlouhy, Susan R Durham, Richard G Ellenbogen, Ramin Eskandari, Timothy M George, Gerald A Grant, Patrick C Graupman, Stephanie Greene, Jeffrey P Greenfield, Naina L Gross, Daniel J Guillaume, Todd C Hankinson, Gregory G Heuer, Mark Iantosca, Bermans J Iskandar, Eric M Jackson, James M Johnston, Robert F Keating, Mark D Krieger, Jeffrey R Leonard, Cormac O Maher, Francesco T Mangano, J Gordon McComb, Sean D McEvoy, Thanda Meehan, Arnold H Menezes, Brent R O'Neill, Greg Olavarria, John Ragheb, Nathan R Selden, Manish N Shah, Chevis N Shannon, Joshua S Shimony, Matthew D Smyth, Scellig S D Stone, Jennifer M Strahle, James C Torner, Gerald F Tuite, Scott D Wait, John C Wellons, William E Whitehead, Tae Sung Park, David D Limbrick
OBJECTIVE: Posterior fossa decompression with duraplasty (PFDD) is commonly performed for Chiari I malformation (CM-I) with syringomyelia (SM). However, complication rates associated with various dural graft types are not well established. The objective of this study was to elucidate complication rates within 6 months of surgery among autograft and commonly used nonautologous grafts for pediatric patients who underwent PFDD for CM-I/SM. METHODS: The Park-Reeves Syringomyelia Research Consortium database was queried for pediatric patients who had undergone PFDD for CM-I with SM...
February 12, 2021: Journal of Neurosurgery. Pediatrics
#31
MULTICENTER STUDY
Travis S CreveCoeur, Alexander T Yahanda, Cormac O Maher, Gabrielle W Johnson, Laurie L Ackerman, P David Adelson, Raheel Ahmed, Gregory W Albert, Phillipp R Aldana, Tord D Alden, Richard C E Anderson, Lissa Baird, David F Bauer, Karin S Bierbrauer, Douglas L Brockmeyer, Joshua J Chern, Daniel E Couture, David J Daniels, Robert C Dauser, Susan R Durham, Richard G Ellenbogen, Ramin Eskandari, Herbert E Fuchs, Timothy M George, Gerald A Grant, Patrick C Graupman, Stephanie Greene, Jeffrey P Greenfield, Naina L Gross, Daniel J Guillaume, Gabe Haller, Todd C Hankinson, Gregory G Heuer, Mark Iantosca, Bermans J Iskandar, Eric M Jackson, Andrew H Jea, James M Johnston, Robert F Keating, Michael P Kelly, Nickalus Khan, Mark D Krieger, Jeffrey R Leonard, Francesco T Mangano, Timothy B Mapstone, J Gordon McComb, Arnold H Menezes, Michael Muhlbauer, W Jerry Oakes, Greg Olavarria, Brent R O'Neill, Tae Sung Park, John Ragheb, Nathan R Selden, Manish N Shah, Chevis Shannon, Joshua S Shimony, Jodi Smith, Matthew D Smyth, Scellig S D Stone, Jennifer M Strahle, Mandeep S Tamber, James C Torner, Gerald F Tuite, Scott D Wait, John C Wellons, William E Whitehead, David D Limbrick
BACKGROUND: Occipital-cervical fusion (OCF) and ventral decompression (VD) may be used in the treatment of pediatric Chiari-1 malformation (CM-1) with syringomyelia (SM) as adjuncts to posterior fossa decompression (PFD) for complex craniovertebral junction pathology. OBJECTIVE: To examine factors influencing the use of OCF and OCF/VD in a multicenter cohort of pediatric CM-1 and SM subjects treated with PFD. METHODS: The Park-Reeves Syringomyelia Research Consortium registry was used to examine 637 subjects with cerebellar tonsillar ectopia ≥ 5 mm, syrinx diameter ≥ 3 mm, and at least 1 yr of follow-up after their index PFD...
January 13, 2021: Neurosurgery
#32
Chia-En Wong, Yi-Shan Tsai, Jiann-Shiuh Chen, Yu-Ning Chen, Jung-Shun Lee
Type I Chiari malformation (CM-I) consists of downward herniation of the cerebellar tonsils below the foramen magnum and often requires surgical decompression if symptomatic. Spontaneous resolution of CM-I is rare. We present a case of resolved CM-I without surgery in a 6-year-old boy with B-cell lymphoma who was diagnosed with CM-I during lymphoma staging. Cerebrospinal fluid cytology and brain MRI revealed negative CNS involvement but showed CM-I with tonsillar ectopia 19 mm below the foramen magnum. The patient underwent induction chemotherapy including 5 doses of intrathecal chemotherapy...
December 4, 2020: Journal of Neurosurgery. Pediatrics
#33
JOURNAL ARTICLE
А Т Faizutdinova, E I Bogdanov
OBJECTIVE: To clarify a role of distinct factors that form the morphological basis of the classical or primary Chiari type 1 malformation (CM1) in the development of its clinical manifestations and subtypes. MATERIAL AND METHODS: The main study group included 710 adult patients with cerebellar ectopia divided into subgroups according to the severity of cerebellar ectopia (less than 2 mm (CM0); 2-4 mm (CM0,5); 5 mm or more (CM1); 5 mm or more in combination with a pronounced prolapse of the brain stem below the foramen magnum (CM1,5)) as well as to the presence of «overcrowded» posterior cranial fossa (PF) and «small» PF...
2020: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
#34
JOURNAL ARTICLE
Blaise Simplice Talla Nwotchouang, Maggie S Eppelheimer, Alaaddin Ibrahimy, James R Houston, Dipankar Biswas, Richard Labuda, Jayapalli Rajiv Bapuraj, Philip A Allen, David Frim, Francis Loth
PURPOSE: While the presence of cerebellar tonsillar descent in radiological images has been used as evidence of Chiari malformation type I (CMI), tonsillar ectopia alone is insufficient to identify individuals with symptomatic CMI. This study sought to identify differences in brain morphology between symptomatic CMI and healthy controls in adult females. METHODS: Two hundred and ten adult females with symptomatic CMI and 90 age- and body mass index-matched asymptomatic female controls were compared using seven brain morphometric measures visible on magnetic resonance images...
May 16, 2020: Neuroradiology
#35
JOURNAL ARTICLE
Brooke Sadler, Timothy Kuensting, Jennifer Strahle, Tae Sung Park, Matthew Smyth, David D Limbrick, Matthew B Dobbs, Gabe Haller, Christina A Gurnett
BACKGROUND: Chiari malformation type 1 affects approximately one in 1,000 people symptomatically, although one in 100 meet radiological criteria, making it a common neurological disorder. The diagnosis of underlying conditions has become more sophisticated, and new radiological markers of disease have been described. We sought to determine the prevalence and impact of additional comorbidities and underlying diagnoses in patients with Chiari malformation type 1 on symptomatology and surgical treatment...
May 2020: Pediatric Neurology
#36
JOURNAL ARTICLE
Susana Calle, Eliana Bonfante, Garrett Simmons, Jason Rogers, Clark Sitton, Katrina Hughes, Ramesh M Papanna, Roy Riascos, Rajan Patel
OBJECTIVE: Our objective is to document the imaging appearance in the intracranial compartment at the time of the infants' first postnatal brain MR imaging after fetal repair for spinal dysraphisms. METHODS: Twenty-nine patients were evaluated on fetal and postnatal magnetic resonance imaging for a series of features of Chiari II malformation. RESULTS: Of the 29 infants, 55% had resolution of tonsillar ectopia, and 62% showed a dorsal outpouching of the near the foramen magnum on postnatal magnetic resonance imaging...
January 2020: Journal of Computer Assisted Tomography
#37
JOURNAL ARTICLE
Dan S Heffez, John Broderick, Michael Connor, Michael Mitchell, JoAnna Galezowska, Ramin Golchini, Jugal Ghorai
BACKGROUND: Chiari 1 malformation is diagnosed if the cerebellar tonsils extend at least 5 mm below the opisthion-basion line. OBJECTIVE: To examine the correlation of the extent of tonsillar ectopia with the prevalence and severity of the symptoms associated with the Chiari malformation. METHODS: Patients (N = 428) were grouped according to the extent of tonsillar ectopia on the mid-sagittal MRI image (group 1, 0-< 3 mm; group 2, 3-5 mm; group 3, > 5 mm)...
December 24, 2019: Acta Neurochirurgica
#38
JOURNAL ARTICLE
Dan S Heffez, Ramin Golchini, Jugal Ghorai, Bernard Cohen
BACKGROUND: The diagnosis of Chiari 1 malformation is based on the extent of tonsillar ectopia. OBJECTIVE: To examine the relationship between the extent of tonsillar ectopia and the intra-operative findings and clinical outcome following Chiari decompression surgery. METHODS: Patients were divided into four groups depending on the position of the cerebellar tonsil (T): group 1: 0 < T < 3; group 2: 3 ≤ T ≤ 5; group 3: 5 < T ≤ 10; and group 4: T > 10...
July 2020: Acta Neurochirurgica
#39
REVIEW
Karel-Bart Celie, Melissa Yuan, Caitlin Hoffman, Ashley O'Connor, Jarrod Bogue, Thomas Imahiyerobo
Patients with syndromic craniosynostosis (CS) can present with both intracranial and extracranial manifestations. Extracranial features include proptosis, exorbitism, and midface hypoplasia. Intracranial manifestations can include elevated intracranial pressure (ICP), brainstem compression, foramen magnum stenosis or jugular foramen hypoplasia with resultant venous hypertension and anomalous drainage. While fronto-orbital advancement, cranial vault remodeling, and posterior fossa decompression are standard surgical approaches to normalizing orbito-cranial volume and morphology, associated hydrocephalus, anomalous venous drainage, and tonsillar herniation often affect the timing, safety, and selection of corrective interventions...
2020: Journal of Craniofacial Surgery
#40
REVIEW
Samuel G McClugage, W Jerry Oakes
As with many pathologies, the course of our understanding of the Chiari I malformation (CIM) has developed extensively over time. The early descriptions of the Chiari malformations by Hans Chiari in 1891 opened the door for future classification and research on this topic. However, even over a long timeframe, our understanding of the pathophysiology and, more importantly, treatment, remained in its infancy. As recently as the 1970s, CIM was not discussed in popular neurology textbooks. Syringomyelia is listed as a degenerative disorder with no satisfactory treatment...
September 1, 2019: Journal of Neurosurgery. Pediatrics
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