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Chiari I

Francesco Giganti, Alessandro Ambrosi, Maria Chiara Petrone, Carla Canevari, Damiano Chiari, Annalaura Salerno, Paolo Giorgio Arcidiacono, Roberto Nicoletti, Luca Albarello, Elena Mazza, Francesca Gallivanone, Luigi Gianolli, Elena Orsenigo, Antonio Esposito, Carlo Staudacher, Alessandro Del Maschio, Francesco De Cobelli
OBJECTIVES: To compare the diagnostic performance of Magnetic Resonance (MR) and diffusion-weighted imaging (DWI), Multidetector Computed Tomography (MDCT), Endoscopic Ultrasonography (EUS) and (18)F-FDG (Fluorodeoxyglucose) Positron Emission Tomography - Computed Tomography (PET-CT) in the preoperative loco-regional staging of oesophageal cancer. METHODS: Eighteen patients with oesophageal or Siewert I tumour (9 directly treated with surgery and 9 addressed to chemo/radiotherapy before) underwent 1...
October 21, 2016: British Journal of Radiology
Thomas Beez, Jennifer Brown
BACKGROUND: Atlanto-occipital dislocation (AOD) is a rare but severe sequela of high energy trauma. Children are at increased risk, due to their immature spine and biomechanical characteristics. LITERATURE REVIEW: The prevailing mechanism of injury is motor vehicle collision as passenger. AOD commonly presents with cardiorespiratory arrest, spinal cord injury or cranial nerve deficits. Concomitant injuries, such as traumatic brain injury, are frequently encountered...
October 18, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Max O Krucoff, Steven Cook, Owoicho Adogwa, Jessica Moreno, Siyun Yang, Jichun Xie, Alexander O Firempong, Nandan Lad, Carlos A Bagley
OBJECT: To examine the role of race, gender, and socioeconomics on presentations and outcomes of adult Chiari 1 malformations. METHODS: The charts of 638 adult patients with Chiari 1 malformations were reviewed, and 287 patients were included. Race, gender, insurance status, symptoms, depth of cerebellar tonsillar herniation, and presence of syringomyelia were examined as covariates in multivariate logistic regression models to identify independent predictors of presentation and outcome...
October 14, 2016: World Neurosurgery
X Qi, G Han, X Guo, V De Stefano, K Xu, Z Lu, H Xu, A Mancuso, W Zhang, X Han, D C Valla, D Fan
BACKGROUND: China may have the largest number of Budd-Chiari syndrome (BCS) cases in the world (at least 1914 original papers were published, and at least 20 191 BCS patients were reported). Considering the discrepancy in the clinical profiles and preferred treatment selection of primary BCS between the West and China, understanding its aetiology in these two different regions is very important. AIM: To review the data from large cohort studies and meta-analyses to illustrate the epidemiology of risk factors for BCS in the West and China...
October 13, 2016: Alimentary Pharmacology & Therapeutics
Daniele Starnoni, Roy Thomas Daniel, Mercy George, Mahmoud Messerer
BACKGROUND: Spontaneous meningoencephaloceles of the lateral sphenoid sinus are rare entities and their peculiar location represent a surgical challenge due to the importance of a wide exposure and skull base reconstruction. They are thought to arise from congenital base defect of the lateral sphenoid or in some cases have been postulated to represent a rare manifestation of altered CSF dynamics. We report the first case in literature of a Chiari malformation type I and a lateral sphenoid encephaloceles revising the theoretical etiology and surgical technique of endoscopic repair...
October 8, 2016: World Neurosurgery
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
Edith V Sullivan, Barton Lane, Dongjin Kwon, M J Meloy, Susan F Tapert, Sandra A Brown, Ian M Colrain, Fiona C Baker, Michael D De Bellis, Duncan B Clark, Bonnie J Nagel, Kilian M Pohl, Adolf Pfefferbaum
Structural MRI of volunteers deemed "normal" following clinical interview provides a window into normal brain developmental morphology but also reveals unexpected dysmorphology, commonly known as "incidental findings." Although unanticipated, these anatomical findings raise questions regarding possible treatment that could even ultimately require neurosurgical intervention, which itself carries significant risk but may not be indicated if the anomaly is nonprogressive or of no functional consequence. Neuroradiological readings of 833 structural MRI from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) cohort found an 11...
October 8, 2016: Brain Imaging and Behavior
Paria Kashani, Madan Roy, Linda Gillis, Olufemi Ajani, M Constantine Samaan
A 19-month-old boy was referred for progressive weight gain. His past medical history included congenital hypothyroidism and developmental delay. Physical examination revealed characteristics of Albright Hereditary Osteodystrophy, macrocephaly, and calcinosis cutis. He had hypocalcemia, hyperphosphatemia, and elevated Parathyroid Hormone levels. Genetic testing revealed a known mutation of GNAS gene, confirming the diagnosis of Pseudohypoparathyroidism Type Ia (PHP-Ia) (c.34C>T (p.G1n12X)). He had a normal brain MRI at three months, but developmental delay prompted a repeat MRI that revealed Chiari Malformation Type I (CM-I) with hydrocephalus requiring neurosurgical intervention...
2016: Case Reports in Medicine
Romeo I Chira, Alina Florea, Simona Manole, Simona Valean
No abstract text is available yet for this article.
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Caterina Rizzo, Christian Napoli, Giulietta Venturi, Simonetta Pupella, Letizia Lombardini, Paolo Calistri, Federica Monaco, Roberto Cagarelli, Paola Angelini, Romeo Bellini, Marco Tamba, Alessandra Piatti, Francesca Russo, Giorgio Palù, Mario Chiari, Antonio Lavazza, Antonino Bella
In Italy a national Plan for the surveillance of imported and autochthonous human vector-borne diseases (chikungunya, dengue, Zika virus disease and West Nile virus (WNV) disease) that integrates human and veterinary (animals and vectors) surveillance, is issued and revised annually according with the observed epidemiological changes. Here we describe results of the WNV integrated veterinary and human surveillance systems in Italy from 2008 to 2015. A real time data exchange protocol is in place between the surveillance systems to rapidly identify occurrence of human and animal cases and to define and update the map of affected areas i...
September 15, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Sandi K Lam, Rory R Mayer, Thomas G Luerssen, I Wen Pan
OBJECTIVES: To develop a cost model for hospitalization costs of surgery among children with Chiari malformation type 1 (CM-1) and to examine risk factors for increased costs. STUDY DESIGN: Data were extracted from the US National Healthcare Cost and Utilization Project 2009 Kids' Inpatient Database. The study cohort was comprised of patients aged 0-20 years who underwent CM-1 surgery. Patient charges were converted to costs by cost-to-charge ratios. Simple and multivariable generalized linear models were used to construct cost models and to determine factors associated with increased hospital costs of CM-1 surgery...
September 21, 2016: Journal of Pediatrics
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
Jennifer Strahle, Cormac O Maher
No abstract text is available yet for this article.
September 9, 2016: Journal of Neurosurgery
Mehmet Selcuki, Mesut Mete, Deniz Selcuki
AIM: The Chiari Malformation I (CM I) and tethered cord syndrome (TCS) are both congenital abnormalities whose mechanism are still not fully understood. Associaton of CM I and TCS have been reported only for a few times previously Material and Methods: This retrospective study includes 7 patients who were diagnosed with CM I and TCS managed by cutting of the filum terminale. RESULTS: The mean follow-up period was 21 months and 28 days. Although all patients were undergone untethering surgical procedure by cutting the filum terminale only, all patients reported significant early postsurgical resolution of CM I symptoms and symptoms related to TCS as well...
July 1, 2016: Turkish Neurosurgery
Charles E Mackel, Patrick J Cahill, Marie Roguski, Amer F Samdani, Patrick A Sugrue, Noriaki Kawakami, Peter F Sturm, Joshua M Pahys, Randal R Betz, Ron El-Hawary, Steven W Hwang
OBJECTIVE The authors performed a study to identify clinical characteristics of pediatric patients diagnosed with Chiari I malformation and scoliosis associated with a need for spinal fusion after posterior fossa decompression when managing the scoliotic curve. METHODS The authors conducted a multicenter retrospective review of 44 patients, aged 18 years or younger, diagnosed with Chiari I malformation and scoliosis who underwent posterior fossa decompression from 2000 to 2010. The outcome of interest was the need for spinal fusion after decompression...
September 2, 2016: Journal of Neurosurgery. Pediatrics
Davis G Taylor, Panagiotis Mastorakos, John A Jane, Edward H Oldfield
OBJECTIVE A subset of patients with Chiari I malformation demonstrate patent subarachnoid spaces around the cerebellum, indicating that reduced posterior fossa volume alone does not account for tonsillar descent. The authors distinguish two subsets of Chiari I malformation patients based on the degree of "posterior fossa crowdedness" on MRI. METHODS Two of the coauthors independently reviewed the preoperative MR images of 49 patients with Chiari I malformation and categorized the posterior fossa as "spacious" or "crowded...
September 2, 2016: Journal of Neurosurgery
Florian Roser, Florian H Ebner, Marina Liebsch, Marcos S Tatagiba, Georgios Naros
OBJECT: Suboccipital decompression and duraplasty is considered the treatment of choice for Chiari-I-malformation. Several studies have shown improvement of neurophysiological parameters during decompressive surgery in pediatric patients. However, there is no evidence of the beneficial role of intraoperative neuromonitoring in adults. METHODS: A total of 39 consecutive patients (25 female, age 41.1±14.5 years [mean±SD]) underwent suboccipital decompression for the treatment of symptomatic Chiari-I-malformation senior neurosurgeon and his team...
November 2016: Clinical Neurology and Neurosurgery
Robert Fruscio, Lorenzo Ceppi, Silvia Corso, Francesca Galli, Tiziana Dell'Anna, Federica Dell'Orto, Daniela Giuliani, Annalisa Garbi, Stefania Chiari, Costantino Mangioni, Rodolfo Milani, Irene Floriani, Nicoletta Colombo, Cristina Maria Bonazzi
BACKGROUND: The objective of this study is to evaluate the safety of fertility-sparing surgery (FSS) for early-stage epithelial ovarian cancer (EOC). METHODS: A retrospective analysis was performed to identify patients treated for early-stage EOC and to compare the clinical outcomes of patients treated with FSS and radical surgery (RS). RESULTS: A total of 1031 patients were treated at two Institutions, 242 with FSS (group A) and 789 with RS (group B)...
September 6, 2016: British Journal of Cancer
Vaishnavi Batmanabane, Elise Heon, Tianyang Dai, Prakash Muthusami, Shiyi Chen, Arun Reginald, Shilpa Radhakrishnan, Manohar Shroff
BACKGROUND: The use of MRI in isolated pediatric nystagmus remains a gray area in clinical management. Many clinicians prefer to order an MRI to rule out intracranial pathology despite the lack of clinically significant findings in most cases. OBJECTIVE: To assess the yield of MR imaging in isolated pediatric nystagmus and define a management algorithm to minimize avoidable MRI referrals and streamline MRI protocols. MATERIALS AND METHODS: We reviewed the charts of 148 children who underwent neuro MRI for isolated nystagmus between January 2008 and September 2014...
August 12, 2016: Pediatric Radiology
Marianne Pozetti, Telmo Augusto Barba Belsuzarri, Natalia C B Belsuzarri, Naira B Seixas, João F M Araujo
BACKGROUND: The association between neurofibromatosis type 1 (NF-I) and Chiari I malformation (CMI) is rare, and not many studies are reported in the literature. Performing magnetic resonance imaging (MRI) in patients with NF-1 is essential because several cases of Chiari type I are completely asymptomatic. We emphasize the need for inclusion of Chiari I as diagnosis in association with NF-1. CASE DESCRIPTION: The patient was a 51-year-old black man who presented with complaints of pain and decreased motion and sensibility of his hands, wrists, and forearms, along with progressive dysarthria...
2016: Surgical Neurology International
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