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Chiari I

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https://www.readbyqxmd.com/read/28637118/asymptomatic-chiari-type-i-malformation-should-patients-be-advised-against-participation-in-contact-sports
#1
Robert Spencer, Paul Leach
BACKGROUND: Chiari type I malformation (CM-I) is characterised by caudal displacement of the cerebellar tonsils through the foramen magnum, crowding the craniocervical junction. It is being increasingly diagnosed in asymptomatic patients due to the widespread availability of MRI, and there are case reports of these patients suffering sudden death or neurological injury following head or neck trauma, raising the issue of whether they should be prohibited from contact sport participation, given the likelihood of frequent trauma...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28637109/closing-the-dura-dural-hitching-versus-surgicel-and-tisseel-overlay-graft-in-craniocervicaldecompression-for-chiari-1-malformation
#2
Michael Tonkins, Naeem Farooqi, Rohan Ahmed, Saurabh Sinha, Debapriya Bhattacharyya
BACKGROUND: This study compares dural hitching to surgicel and tisseel overlay graft following craniocervical decompression and C1 laminectomy with simple durotomy for Chiari I malformation. Outcome measures were syrinx decompression, headache resolution and complication rates. METHODS: A retrospective analysis of case notes was conducted. Patients who had undergone craniocervical decompression (CCD) were grouped by method of dural closure. Outcomes compared were rates of syrinx decompression, headache resolution, and post-operative complications...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28612426/embryology-and-pathophysiology-of-the-chiari-i-and-ii-malformations-a-comprehensive-review
#3
REVIEW
Mohammadali M Shoja, Jaspreet Johal, W Jerry Oakes, R Shane Tubbs
Although the Chiari malformations are well-studied and described developmental anomalies, there remains some incongruity in regards to their underlying etiologies. A number of theories have been proposed with the purpose of accounting for the embryology and pathogenesis of the Chiari I and II malformations and their associated complications and clinical syndromes. The present review aims to review the pertinent literature for all of the main theories that have been proposed, and outline their validity and relevance to our contemporary understanding of these anomalies...
June 13, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28607814/chiari-i-malformation-and-syringomyelia-in-mucopolysaccharidosis-type-i-hurler-syndrome-treated-with-posterior-fossa-decompression-case-report-and-review-of-the-literature
#4
Vyacheslav Makler, Christina L Goldstein, Daniel Hoernschemeyer, Tomoko Tanaka
BACKGROUND: Hurler Syndrome is the most severe phenotype of mucopolysaccharidosis type I. With bone marrow transplant and enzyme replacement therapy, the life expectancy of a child with Hurler syndrome has been extended, predisposing them to multiple musculoskeletal issues most commonly involving the spine. CASE DESCRIPTION: This is the case report of a 6-year-old male with Hurler syndrome who was diagnosed with Chiari I malformation and cervicothoracic syringomyelia on a preoperative magnetic resonance imaging (MRI) for his thoracolumbar kyphosis...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28598265/robot-assisted-endoscopic-third-ventriculostomy-institutional-experience-in-9-patients
#5
Reid Hoshide, Mark Calayag, Hal Meltzer, Michael L Levy, David Gonda
OBJECTIVE The endoscopic third ventriculostomy (ETV) is an established and effective treatment for obstructive hydrocephalus. In its most common application, surgeons plan their entry point and the endoscope trajectory for the procedure based on anatomical landmarks, then control the endoscope freehand. Recent studies report an incidence of neural injuries as high as 16.6% of all ETVs performed in North America. The authors have introduced the ROSA system to their ETV procedure to stereotactically optimize endoscope trajectories, to reduce risk of traction on neural structures by the endoscope, and to provide a stable mechanical holder of the endoscope...
June 9, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28589373/3d-structural-complexity-analysis-of-cerebellum-in-chiari-malformation-type-i
#6
Engin Akar, Sadık Kara, Hidayet Akdemir, Adem Kırış
Chiari malformation type I (CM-I), described by a descent of the cerebellar tonsils, is assumed to be a neurological developmental disorder. The aim of the present study was to investigate morphological variance in cerebellar sub-structures, including gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF), using magnetic resonance (MR) images with three-dimensional (3D) fractal dimension (FD) analysis in patients with CM-I. MRI data of 16 patients and 15 control subjects were obtained, and structural complexity analyses were performed using a box-counting FD algorithm...
June 7, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28586935/endoscopic-management-of-arnold-chiari-malformation-type-i-with-or-without-syringomyelia
#7
Shailendra Ratre, Nishtha Yadav, Yad Ram Yadav, Vijay Singh Parihar, Jitin Bajaj, Yatin Kher
Introduction Several different surgical techniques have been used in the treatment of patients with symptomatic Arnold-Chiari malformation type 1 (ACM-1) with or without syrinx. Endoscope-assisted decompression of the posterior fossa has been found to be safe and effective. We report our initial experience of endoscopic management of ACM-I. Material and Methods This was a prospective study of 15 symptomatic patients. Pre- and postoperative clinical status and computed tomography and magnetic resonance imaging findings were recorded...
June 6, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28585676/evaluation-of-apparent-diffusion-coefficients-in-the-cerebellar-tonsils-and-bulbus-in-chiari-type-i-malformations-comparison-before-and-after-surgery
#8
Bekir Akgun, Sait Ozturk, Ismail Taskent, Mehmet Besir Surme, Fatih Serhat Erol, Hanefi Yildirim
AIM: To evaluate the preoperative and postoperative 6th month mean apparent diffusion coefficient (ADC) values of the cerebellar tonsils and bulbus in patients with Chiari Malformation Type I (CMI), and to compare the results with healthy controls. MATERIAL AND METHODS: We included 15 patients with CMI who underwent suboccipital decompression, upper cervical laminectomy, and duraplasty surgery, and compared them with 10 healthy individuals. Three regions of interest were placed, one each in the cerebellar tonsils and one in the bulbus...
May 7, 2017: Turkish 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/28537458/chiari-i-malformation-in-children-with-transverse-myelitis
#10
Sathya Vadivelu, Sudhakar Vadivelu, Maureen Mealy, Smurti Patel, Libby Kosnik-Infinger, Daniel Becker
PURPOSE: Transverse myelitis (TM) is an acute inflammatory spinal cord injury. Asymptomatic Chiari I malformation (CMI) management is highly controversial, particularly when associated with a spinal syrinx. Here, we assess the occurrence of CMI in the pediatric TM population and management outcomes. METHODS: We performed a retrospective cohort study based on 61 consecutively identified pediatric TM cases over an -8-year period. We reviewed demographic characteristics, radiographic findings, presenting symptoms, and long-term outcomes...
May 24, 2017: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/28537352/is-pseudotumor-cerebri-an-unusual-expression-of-chiari-syndrome-a-case-report-and-review-of-the-literature
#11
Paolo Pacca, Roberto Altieri, Francesco Zenga, Diego Garbossa, Alessandro Ducati, Michele Lanotte
The Chiari I malformation (CM-I) is a developmental alteration of the posterior cranial fossa (PCF), radiographically defined as the descent of the cerebellar tonsils = 5 mm below the foramen magnum (FM) inside the cervical canal. Headache is the most frequent symptom associated with CM-I. The association of CM-I and neurological symptoms configures with Chiari syndrome. A rare symptom associated with Chiari syndrome is intracranial hypertension syndrome with cephalea and papilloedema-the typical findings of pseudotumor cerebri (PTC)...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28536490/apparent-diffusion-coefficient-by-diffusion-weighted-magnetic-resonance-imaging-as-a-sole-biomarker-for-staging-and-prognosis-of-gastric-cancer
#12
Francesco Giganti, Alessandro Ambrosi, Damiano Chiari, Elena Orsenigo, Antonio Esposito, Elena Mazza, Luca Albarello, Carlo Staudacher, Alessandro Del Maschio, Francesco De Cobelli
OBJECTIVE: To investigate the role of apparent diffusion coefficient (ADC) from diffusion-weighted magnetic resonance imaging (DW-MRI) when applied to the 7th TNM classification in the staging and prognosis of gastric cancer (GC). METHODS: Between October 2009 and May 2014, a total of 89 patients with non-metastatic, biopsy proven GC underwent 1.5T DW-MRI, and then treated with radical surgery. Tumor ADC was measured retrospectively and compared with final histology following the 7th TNM staging (local invasion, nodal involvement and according to the different groups - stage I, II and III)...
April 2017: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/28527081/chiari-malformation-type-1-related-headache-the-importance-of-a-multidisciplinary-study
#13
Marcella Curone, L G Valentini, I Vetrano, E Beretta, M- Furlanetto, L Chiapparini, A Erbetta, G Bussone
Chiari type 1 Malformation (CM 1) is a structural defect consisting of a displacement of the cerebellar tonsils through the foramen magnum causing obstruction of cerebrospinal fluid (CSF) outflow. CM 1 has a variety of presentation with headache being the most common symptom. The evaluation and treatment of headache related to CM 1 are often difficult, because the pain in the occipital-suboccipital region or headache that is of cough-type suggests symptomatic CM 1, but patients suffering from CM 1 can also report migraine or tension-type headache...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28524792/analysis-and-interrater-reliability-of-pb-c2-using-mri-and-ct-data-from-the-park-reeves-syringomyelia-research-consortium-on-behalf-of-the-pediatric-craniocervical-society
#14
Todd C Hankinson, Gerald F Tuite, Dagmara I Moscoso, Leslie C Robinson, James C Torner, David D Limbrick, Tae Sung Park, Richard C E Anderson
OBJECTIVE The distance to the ventral dura, perpendicular to the basion to C2 line (pB-C2), is commonly employed as a measure describing the anatomy of the craniovertebral junction. However, both the reliability among observers and the clinical utility of this measurement in the context of Chiari malformation Type I (CM-I) have been incompletely determined. METHODS Data were reviewed from the first 600 patients enrolled in the Park-Reeves Syringomyelia Research Consortium with CM-I and syringomyelia. Thirty-one cases were identified in which both CT and MRI studies were available for review...
May 19, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28523220/cardiovascular-risk-factors-in-chiari-malformation-and-idiopathic-intracranial-hypertension
#15
Radek Frič, Are Hugo Pripp, Per Kristian Eide
OBJECTIVES: Both Chiari malformation type 1 (CMI, i.e., the idiopathic caudal ectopy of cerebellar tonsils into foramen magnum) and idiopathic intracranial hypertension (IIH) are characterized by reduced intracranial compliance (ICC) due to disturbed circulation of cerebrospinal fluid (CSF). An increasing body of evidence links cardiovascular disease to CSF circulation disturbances. The aim of this study was to explore whether the prevalence of cardiovascular risk factors in patients with CMI or IIH is higher than in the general population...
May 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28516323/diffusion-tensor-imaging-findings-of-the-brainstem-in-subjects-with-tonsillar-ectopia
#16
Serpil Kurtcan, Alpay Alkan, Huseyin Yetis, Umit Tuzun, Ayse Aralasmak, Huseyin Toprak, Huseyin Ozdemir
We aimed to evaluate the differences between apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) values obtained from different cranial sites in subjects with Chiari I Malformation (CM-I) and borderline tonsillar ectopia (BTE), and to determine correlations between diffusion tensor imaging (DTI) metrics and the severity of tonsillar ectopia. A total of 73 subjects with CM-I and BTE and 35 control underwent MRI and DTI. In our study, ADC values measured from the level of medulla oblongata and the RD values measured in middle cerebellar peduncles, thalamus, and globus pallidus were higher in CM-I patients than in controls...
May 17, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28513615/exome-sequencing-of-two-italian-pedigrees-with-non-isolated-chiari-malformation-type-i-reveals-candidate-genes-for-cranio-facial-development
#17
Elisa Merello, Lorenzo Tattini, Alberto Magi, Andrea Accogli, Gianluca Piatelli, Marco Pavanello, Domenico Tortora, Armando Cama, Zoha Kibar, Valeria Capra, Patrizia De Marco
Chiari malformation type I (CMI) is a congenital abnormality of the cranio-cerebral junction with an estimated incidence of 1 in 1280. CMI is characterized by underdevelopment of the occipital bone and posterior fossa (PF) and consequent cerebellar tonsil herniation. The presence for a genetic basis to CMI is supported by many lines of evidence. The cellular and molecular mechanisms leading to CM1 are poorly understood. The occipital bone formation is dependent on complex interactions between genes and molecules with pathologies resulting from disruption of this delicate process...
May 17, 2017: European Journal of Human Genetics: EJHG
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
#18
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/28498073/does-the-mesodermal-derangement-in-chiari-type-i-malformation-extend-to-the-cervical-spine-evidence-from-an-analytical-morphometric-study-on-cervical-paraspinal-muscles
#19
Sumit Thakar, Avinash Kurudi Siddappa, Saritha Aryan, Dilip Mohan, Narayanam Anantha Sai Kiran, Alangar S Hegde
OBJECTIVE The mesodermal derangement in Chiari Type I malformation (CMI) has been postulated to encompass the cervical spine. The objectives of this study were to assess the cross-sectional areas (CSAs) of cervical paraspinal muscles (PSMs) in patients with CMI without syringomyelia, compare them with those in non-CMI subjects, and evaluate their correlations with various factors. METHODS In this retrospective study, the CSAs of cervical PSMs in 25 patients were calculated on T2-weighted axial MR images and computed as ratios with respect to the corresponding vertebral body areas...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28490224/prevalence-of-abnormal-magnetic-resonance-imaging-findings-in-children-with-persistent-symptoms-after-pediatric-sports-related-concussion
#20
Robert H Bonow, Seth D Friedman, Francisco A Perez, Richard G Ellenbogen, Samuel R Browd, Christine L MacDonald, Monica S Vavilala, Frederick P Rivara
A subset of patients experience persistent symptoms after pediatric concussion, and magnetic resonance imaging (MRI) is commonly used to evaluate for pathology. The utility of this practice is unclear. We conducted a retrospective cohort study to describe the MRI findings in children with concussion. A registry of all patients seen at our institution from January 2010 through March 2016 with pediatric sports-related concussion was cross-referenced with a database of radiographic studies. Radiology reports were reviewed for abnormal findings...
May 10, 2017: Journal of Neurotrauma
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