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chiari malformation flow

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https://www.readbyqxmd.com/read/29125433/a-points-based-algorithm-for-prognosticating-clinical-outcome-of-chiari-malformation-type-i-with-syringomyelia-results-from-a-predictive-model-analysis-of-82-surgically-managed-adult-patients
#1
Sumit Thakar, Laxminadh Sivaraju, Kuruthukulangara S Jacob, Aditya Atal Arun, Saritha Aryan, Dilip Mohan, Narayanam Anantha Sai Kiran, Alangar S Hegde
OBJECTIVE Although various predictors of postoperative outcome have been previously identified in patients with Chiari malformation Type I (CMI) with syringomyelia, there is no known algorithm for predicting a multifactorial outcome measure in this widely studied disorder. Using one of the largest preoperative variable arrays used so far in CMI research, the authors attempted to generate a formula for predicting postoperative outcome. METHODS Data from the clinical records of 82 symptomatic adult patients with CMI and altered hindbrain CSF flow who were managed with foramen magnum decompression, C-1 laminectomy, and duraplasty over an 8-year period were collected and analyzed...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29096983/chiari-malformation-may-increase-perivascular-cerebrospinal-fluid-flow-into-the-spinal-cord-a-subject-specific-computational-modelling-study
#2
Robert A Lloyd, David F Fletcher, Elizabeth C Clarke, Lynne E Bilston
Syringomyelia is associated with Chiari I malformation, although the mechanistic link is unclear. Studies have suggested that cerebrospinal fluid enters the spinal cord via the perivascular spaces, and that changes in the timing of the subarachnoid pressures may increase flow into the spinal cord. This study aims to determine how Chiari malformation and syringomyelia alter the subarachnoid space pressures and hence perivascular flow. Subject-specific models of healthy controls (N = 9), Chiari patients with (N = 7) and without (N = 8) syringomyelia, were developed from magnetic resonance imaging (MRI), to simulate the subarachnoid pressures...
October 25, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29071044/chiari-type-i-malformation-with-cervicothoracic-syringomyelia-subterfuge-as-flail-arm-syndrome
#3
Zhi Gang Lan, Seidu A Richard, Jiagang Liu, Chao You
Chiari type I malformation with cervicothoracic syringomyelia although very common in clinical practice usually in children can progress slowly and mimic muscular dystrophies in adulthood. We present a rare adult case of Chiari type I malformation with cervicothoracic syringomyelia subterfuge as Flail arm syndrome. A 44-year-old man was diagnosed with congenital type I Chiari malformation with cervicothoracic syringomyelia about 21 years ago without surgery. His health status deteriorated over the years until 21 days prior to presentation when he had severe pain in the right knee...
August 29, 2017: Neurology International
https://www.readbyqxmd.com/read/29027876/intradural-pathology-and-pathophysiology-associated-with-chiari-i-malformation-in-children-and-adults-with-and-without-syringomyelia
#4
Brian J Dlouhy, Jeffrey D Dawson, Arnold H Menezes
OBJECTIVE The pathophysiology underlying tonsillar herniation and CSF obstruction in Chiari malformation Type I (CM-I) is unclear, and the cause of CM-I-associated syringomyelia is not well understood. A better understanding of this pathophysiology is important for an improved treatment strategy. Therefore, the authors sought to identify, characterize, and examine the intradural pathology and CSF flow pathophysiology in the posterior fossa and at the level of the foramen magnum that occurs in the setting of CM-I...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28961100/an-mri-compatible-hydrodynamic-simulator-of-cerebrospinal-fluid-motion-in-the-cervical-spine
#5
Suraj Thyagaraj, Soroush H Pahlavian, Lucas R Sass, Francis Loth, Morteza Vatani, Jao-Won Choi, R Shane Tubbs, Daniel Giese, Jan-Robert Kroger, Alexander C Bunck, Bryn A Martin
GOAL: Develop and test an MRI-compatible hydrodynamic simulator of cerebrospinal fluid (CSF) motion in the cervical spinal subarachnoid space. Four anatomically realistic subject-specific models were created based on a 22-year-old healthy volunteer and a five-year-old patient diagnosed with Chiari I malformation. METHODS: The in vitro models were based on manual segmentation of high-resolution T2-weighted MRI of the cervical spine. Anatomically realistic dorsal and ventral spinal cord nerve rootlets (NR) were added...
September 26, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28756364/chiari-i-malformation-with-underlying-pseudotumor-cerebri-poor-symptom-relief-following-posterior-decompression-surgery
#6
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...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28684453/syringohydromyelia-in-patients-with-chiari-i-malformation-a-retrospective-analysis
#7
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...
September 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
#8
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
#9
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
#10
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...
October 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28357166/spontaneous-intracranial-hypotension-presenting-as-a-pseudo-chiari-1
#11
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
#12
REVIEW
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
#13
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
#14
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...
October 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
#15
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
#16
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
#17
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
#18
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 space (SAS) of a healthy subject and 2 Chiari patients by performing highly resolved direct numerical simulation. The lattice Boltzmann method is used for the simulations because of its scalability on modern supercomputers that allow us to simulate up to approximately 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
#19
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
#20
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
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