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https://www.readbyqxmd.com/read/28756364/chiari-i-malformation-with-underlying-pseudotumor-cerebri-poor-symptom-relief-following-posterior-decompression-surgery
#1
Ahmed Alnemari, Tarek R Mansour, Stephanie Gregory, William K Miller, Mark Buehler, Daniel Gaudin
INTRODUCTION: 
 Pseudotumor cerebri (PTC) patients exhibit clear clinical signs and symptoms of higher intracranial pressure (ICP) without ventricular enlargement or mass lesions. The clinical picture of patients with PTC can sometimes be similar to that of Chiari Malformation type I (CMI). There is some evidence that Chiari I malformation and PTC may coexist, which raises the question of whether PTC is an idiopathic disease or a complication of posterior decompression surgery-treatment of choice for Chiari I malformation...
July 22, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28684453/syringohydromyelia-in-patients-with-chiari-i-malformation-a-retrospective-analysis
#2
K A Gad, D M Yousem
BACKGROUND AND PURPOSE: The association of syringohydromyelia with Chiari I malformation has a wide range, between 23% and 80% of cases in the current literature. In our experience, this range might be overestimated compared with our observations in clinical practice. Because there is an impact of Chiari I malformation-associated syringohydromyelia on morbidity and surgical intervention, its diagnosis is critical in this patient population. Identifying related variables on the basis of imaging would also help identify those patients at risk of syrinx formation during their course of disease...
July 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28583457/vertebrobasilar-insufficiency-due-to-distal-posterior-inferior-cerebellar-artery-compression-in-chiari-1-5
#3
M Burhan Janjua, Iryna Ivasyk, Jeffrey P Greenfield
BACKGROUND: Chiari malformation is characterized by radiographic evidence of herniation of cerebellar tonsils below the foramen magnum and a symptom complex of headaches; breathing, swallowing, or sleep difficulties; ataxia; restless; and motor and/or sensory deficits. CASE DESCRIPTION: We report a case of a 34-year-old woman whose imaging indicated a Chiari 1.5 with brainstem (caudal medulla) herniation and an expansive cervical syrinx. Her symptom complex showed signs both of cervical syringomyelia, as well as ones localizable to the medulla...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28564670/current-concepts-in-the-pathogenesis-diagnosis-and-management-of-type-i-chiari-malformations
#4
Cody A Doberstein, Radmehr Torabi, Petra M Klinge
Type 1 Chiari malformations (CMs) are a group of congenital or acquired disorders which include the abnormal presence of the cerebellar tonsils in the upper spinal canal, rather than the posterior fossa. The resulting anatomic abnormality causes crowding of the structures at the craniocervical junction and can impair the normal flow of cerebral spinal fluid (CSF) in this region. This impairment in CSF flow dynamics can led to the development of syringomyelia or hydrocephalus. Type 1 CMs have been associated with a wide array of symptoms resulting from either cerebellar and brainstem compression and distortion or disturbances in CSF dynamics, and can affect both children and adults...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28508159/constant-dripping-wears-away-the-bone-intraosseous-c2-and-suboccipital-intradiploic-cerebrospinal-fluid-collection-after-chiari-i-decompressive-surgery
#5
Arthur R Kurzbuch, Shailendra Magdum
The objective of decompressive surgery for Chiari I malformation is to create additional space to accommodate the ectopic cerebellar tonsils and to improve the flow of cerebrospinal fluid. To the best of our knowledge, we report the first case of a patient with previous Chiari I decompression presenting 5 years after surgery at the same time as an intraosseous C2 and a suboccipital intradiploic cerebrospinal fluid accumulation. Because of the progressive nature of the C2 cerebrospinal fluid collection causing bone destruction, surgical management was indicated...
May 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28357166/spontaneous-intracranial-hypotension-presenting-as-a-pseudo-chiari-1
#6
Ali S Haider, Suraj Sulhan, Ian T Watson, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Spontaneous intracranial hypotension (SIH) is classified as a decrease in cerebrospinal fluid (CSF) pressure secondary to a CSF leakage and consequent descent of the brain into the foramen magnum. Diagnosing SIH can be difficult due to its overlapping findings with Arnold-Chiari type 1 Malformation (CM1) where the cerebellar tonsils herniate into the foramen magnum. The similarity of both conditions calls for a more reliable imaging technique to localize the CSF leak which could narrow the differential diagnosis and aid in choosing the correct treatment...
February 16, 2017: Curēus
https://www.readbyqxmd.com/read/28347422/cord-cystic-cavities-syringomyelia-and-prominent-central-canal
#7
Blaise V Jones
Syringomyelia is the term given to cystic cavities in the spinal cord, most of which are associated with congenital malformations of the craniocervical junction and represent dilation of the central canal of the cord. As such, syrinxes can be considered analogous to hydrocephalus. The exact etiology of syrinx formation remains a subject of debate, but there is ample evidence that they are the result of obstruction of the normal flow of cerebrospinal fluid between the intracranial and spinal compartments. The chances that a syrinx will progress over time are much greater when they are associated with a causative lesion (Chiari malformation, tumor, infection, and trauma), but asymptomatic central canal dilation may be a stable incidental finding...
April 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28192262/intraoperative-ultrasonography-for-definition-of-less-invasive-surgical-technique-in-patients-with-chiari-type-i-malformation
#8
Roger Schmidt Brock, Mario Augusto Taricco, Matheus Fernandes de Oliveira, Marcelo de Lima Oliveira, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu
INTRODUCTION: Chiari malformation type I (CM) is the main congenital malformation disease of the craniovertebral junction. The ideal surgical treatment is still controversial. Invasive procedures inside the cerebrospinal fluid (CSF) space and associated with dural repair are considered the gold standard; however, less invasive surgery with isolated bone decompression without dural opening may be possible in selected patients. Our study evaluates the efficacy of intraoperative CSF flow measurement with ultrasonography (USG) as a determining parameter in the selection of these patients...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28181025/surgical-management-of-chiari-i-malformation-based-on-different-cerebrospinal-fluid-flow-patterns-at-the-cranial-vertebral-junction
#9
Tao Fan, HaiJun Zhao, XinGang Zhao, Cong Liang, YinQian Wang, QiFei Gai
Chiari I malformation has been shown to present different cerebrospinal fluid (CSF) flow patterns at the cranial-vertebral junction (CVJ). Posterior fossa decompression is the first-line treatment for symptomatic Chiari I malformation. However, there is still controversy on the indication and selection of decompression procedures. This research aims to investigate the clinical indications, outcomes, and complications of the decompression procedures as alternative treatments for Chiari I malformation, based on the different CSF flow patterns at the cranial-vertebral junction...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28122014/use-of-morphometric-mapping-to-characterise-symptomatic-chiari-like-malformation-secondary-syringomyelia-and-associated-brachycephaly-in-the-cavalier-king-charles-spaniel
#10
Susan P Knowler, Chloe Cross, Sandra Griffiths, Angus K McFadyen, Jelena Jovanovik, Anna Tauro, Zoha Kibar, Colin J Driver, Roberto M La Ragione, Clare Rusbridge
OBJECTIVES: To characterise the symptomatic phenotype of Chiari-like malformation (CM), secondary syringomyelia (SM) and brachycephaly in the Cavalier King Charles Spaniel using morphometric measurements on mid-sagittal Magnetic Resonance images (MRI) of the brain and craniocervical junction. METHODS: This retrospective study, based on a previous quantitative analysis in the Griffon Bruxellois (GB), used 24 measurements taken on 130 T1-weighted MRI of hindbrain and cervical region...
2017: PloS One
https://www.readbyqxmd.com/read/28094426/the-role-of-cine-flow-magnetic-resonance-imaging-in-patients-with-chiari-0-malformation
#11
Kerem Mazhar Ozsoy, Kadir Oktay, Nuri Eralp Cetinalp, Yurdal Gezercan, Tahsin Erman
AIM: The aim of this study was to define the role of phase-contrast cine magnetic resonance imaging in deciding the therapeutic strategy and underlying pathophysiology resulting in syrinx formation in patients with Chiari type 0 malformation. MATERIAL AND METHODS: Seven patients admitted to our clinic with diagnosis of Chiari 0 malformations during the period January 2005 to July 2016 were enrolled in the study. All patients underwent a detailed preoperative neurological examination...
December 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27911244/neurosurgical-management-in-lateral-meningocele-syndrome-case-report
#12
Erik C Brown, Kunal Gupta, Christina Sayama
Lateral meningocele syndrome (LMS) is a rare genetic connective tissue disorder. It is associated with morphological changes similar to those of other connective tissue disorders, with the unique distinction of multiple, often bilateral and large, lateral meningoceles herniating through the spinal foramina. In some cases, these lateral meningoceles can cause pain and discomfort due to their presence within retroperitoneal tissues or cause direct compression of the spinal nerve root exiting the foramen; in some cases compression may also involve motor weakness...
February 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27863152/direct-numerical-simulation-of-transitional-hydrodynamics-of-the-cerebrospinal-fluid-in-chiari-i-malformation-the-role-of-cranio-vertebral-junction
#13
Kartik Jain, Geir Ringstad, Per-Kristian Eide, Kent-André Mardal
Obstruction to the cerebrospinal fluid (CSF) outflow caused by the herniation of cerebellar tonsils as a result of Chiari malformation type I leads to altered CSF hydrodynamics. This contribution explores the minutest characteristics of the CSF hydrodynamics in cervical subarachnoid spaces (SAS) of a healthy subject and two Chiari patients by performing highly resolved direct numerical simulation. The Lattice Boltzmann method is used for the simulations due to its scalability on modern supercomputers that allow us to simulate up to  ∼ 10(9) cells while resolving the Kolmogorov microscales...
November 10, 2016: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/27743249/the-association-between-the-pulse-pressure-gradient-at-the-cranio-cervical-junction-derived-from-phase-contrast-magnetic-resonance-imaging-and-invasively-measured-pulsatile-intracranial-pressure-in-symptomatic-patients-with-chiari-malformation-type-1
#14
Radek Frič, Erika Kristina Lindstrøm, Geir Andre Ringstad, Kent-André Mardal, Per Kristian Eide
BACKGROUND: In symptomatic Chiari malformation type 1 (CMI), impaired intracranial compliance (ICC) is associated with an increased cranio-spinal pulsatile pressure gradient. Phase-contrast magnetic resonance imaging (MRI) represents a non-invasive modality for the assessment of the pulse pressure gradient at the cranio-cervical junction (CCJ). We wished to explore how the MRI-derived pulse pressure gradient (MRI-dP) compares with invasively measured pulsatile intracranial pressure (ICP) in CMI, and with healthy controls...
December 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27727298/computational-investigation-of-cerebrospinal-fluid-dynamics-in-the-posterior-cranial-fossa-and-cervical-subarachnoid-space-in-patients-with-chiari-i-malformation
#15
Karen-Helene Støverud, Hans Petter Langtangen, Geir Andre Ringstad, Per Kristian Eide, Kent-Andre Mardal
PURPOSE: Previous computational fluid dynamics (CFD) studies have demonstrated that the Chiari malformation is associated with abnormal cerebrospinal fluid (CSF) flow in the cervical part of the subarachnoid space (SAS), but the flow in the SAS of the posterior cranial fossa has received little attention. This study extends previous modelling efforts by including the cerebellomedullary cistern, pontine cistern, and 4th ventricle in addition to the cervical subarachnoid space. METHODS: The study included one healthy control, Con1, and two patients with Chiari I malformation, P1 and P2...
2016: PloS One
https://www.readbyqxmd.com/read/27651871/surgical-outcome-of-adult-idiopathic-chiari-malformation-type-1
#16
Woon Tak Yuh, Chi Heon Kim, Chun Kee Chung, Hyun-Jib Kim, Tae-Ahn Jahng, Sung Bae Park
OBJECTIVE: The pathophysiology of idiopathic Chiari malformation (CM) type 1 is disturbance of free cerebrospinal fluid (CSF) flow and restoration of normal CSF flow is the mainstay of treatment. Additional migration of the medulla oblongata in pediatric patients is referred to as CM type 1.5, but its significance in adult patients is unknown. This study is to compare surgical outcomes of adult idiopathic CM type 1.5 with that of type 1. METHODS: Thirty-eight consecutive adult patients (M : F=11 : 27; median, 33...
September 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27515195/a-unifying-hypothesis-for-hydrocephalus-and-the-chiari-malformations-part-two-the-hydrocephalus-filling-mechanism
#17
Helen Williams
It is proposed that negative central nervous system (CNS) pressure is one of the filling mechanisms of the fluid spaces of the CNS. Negative CNS pressure is caused by the combination of gravitational force and body movement. The venous system imposes pressure fluctuations on the CNS due to changes in posture and body cavity pressure. It is proposed here that filling of veins, arteries and cerebrospinal (CSF) spaces are all assisted by negative CNS pressure. Hyperemia in the CNS in response to pressure changes with movement was described in the first part of this hypothesis...
September 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27494782/magnetic-resonance-imaging-based-measures-predictive-of-short-term-surgical-outcome-in-patients-with-chiari-malformation-type-i-a-pilot-study
#18
Noam Alperin, James Ryan Loftus, Ahmet M Bagci, Sang H Lee, Carlos J Oliu, Ashish H Shah, Barth A Green
OBJECTIVE This study identifies quantitative imaging-based measures in patients with Chiari malformation Type I (CM-I) that are associated with positive outcomes after suboccipital decompression with duraplasty. METHODS Fifteen patients in whom CM-I was newly diagnosed underwent MRI preoperatively and 3 months postoperatively. More than 20 previously described morphological and physiological parameters were derived to assess quantitatively the impact of surgery. Postsurgical clinical outcomes were assessed in 2 ways, based on resolution of the patient's chief complaint and using a modified Chicago Chiari Outcome Scale (CCOS)...
January 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27217656/syringomyelia-secondary-to-occult-dorsal-arachnoid-webs-report-of-two-cases-with-review-of-literature
#19
Parag P Sayal, Arif Zafar, Thomas A Carroll
In a certain group of patients with syringomyelia, even with the advent of sophisticated magnetic resonance imaging (MRI), no associated abnormality or cerebrospinal fluid (CSF) block is easily identified. This type of syringomyelia is often termed idiopathic. Current literature has less than 10 reports of arachnoid webs to be the causative factor. We present our experience in the management of two cases of syringomyelia secondary to arachnoid webs. Both our patients presented with progressive neurological deterioration with MRI scans demonstrating cervical/thoracic syrinx without Chiari malformation or low-lying cord...
April 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27126910/syringomyelia-caused-by-traumatic-intracranial-hypotension-case-report-and-literature-review
#20
Sébastien Richard, Lisa Humbertjean, Gioia Mione, Marc Braun, Emmanuelle Schmitt, Sophie Colnat-Coulbois
BACKGROUND: Syringomyelia due to intracranial hypotension is rarely described. As a consequence, intracranial hypotension is less recognized as a potential cause of syringomyelia or mistaken with Chiari type 1 malformation. The pathogeny is poorly understood, and we lack diagnostic and therapeutic strategies for this particular setting. CASE DESCRIPTION: We describe a 45-year-old patient who developed syringomyelia after about 10 years of undiagnosed intracranial hypotension caused by traumatic C6 cerebrospinal fluid (CSF) leak...
July 2016: World Neurosurgery
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