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Chiari literature

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15 papers 0 to 25 followers
R Shane Tubbs, Huang Yan, Amin Demerdash, Joshua J Chern, Fabian N Fries, Rod J Oskouian, W Jerry Oakes
BACKGROUND: We hypothesized that by using coronal MRI, Chiari I malformation could be more precisely diagnosed, would provide simple anatomic landmarks, would provide information regarding asymmetry of hindbrain herniation, and would be a better method for analyzing the tonsillar herniation postoperatively when the opisthion has been removed. METHODS: Fifty consecutive pediatric patients diagnosed with Chiari I malformation had comparison between the measurements of their caudally descended cerebellar tonsils on midsagittal and coronal MRI images...
July 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Aaron F Struck, Carrie M Carr, Vinil Shah, John R Hesselink, Victor M Haughton
INTRODUCTION: The cervical spine in Chiari I patient with syringomyelia has significantly different anteroposterior diameters than it does in Chiari I patients without syringomyelia. We tested the hypothesis that patients with idiopathic syringomyelia (IS) also have abnormal cervical spinal canal diameters. The finding in both groups may relate to the pathogenesis of syringomyelia. METHODS: Local institutional review boards approved this retrospective study. Patients with IS were compared to age-matched controls with normal sagittal spine MR...
August 2016: Neuroradiology
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
Adriaan R E Potgieser, Eelco W Hoving
PURPOSE: The acquired Chiari I malformation with abnormal cranial vault thickening is a rare late complication of supratentorial shunting. It poses a difficult clinical problem, and there is debate about the optimal surgical strategy. Some authors advocate supratentorial skull enlarging procedures while others prefer a normal Chiari decompression consisting of a suboccipital craniectomy, with or without C1 laminectomy and dural patch grafting. METHODS: We illustrate three cases of symptomatic acquired Chiari I malformation due to inward cranial vault thickening...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Sunil Munakomi, Binod Bhattarai, Pramod Chaudhary
Acute obstructive hydrocephalus due to infratentorial extra-axial fluid collection (EAFC) is an extremely rare complication of foramen magnum decompression (FMD) and durotomy for Chiari malformation type I. Presence of infratentorial  EAFC invariably causes obstruction at the level of the fourth ventricle or aqueduct of Silvius, thereby indicating its definitive role in hydrocephalus. Pathogenesis of EAFC is said to be a local arachnoid tear as a result of durotomy, as this complication is not described in FMD without durotomy...
2016: F1000Research
Hao Xu, LinYang Chu, Rui He, Chang Ge, Ting Lei
The treatment of Chiari malformation type 1 (CM-I) with posterior fossa decompression without (PFD) or with duraplasty (PFDD) is controversial. Our aim is to compare the clinical outcome between the two methods for the treatment of CM-I. In this paper, the authors report a systematic review and meta-analysis of operation time, clinical improvement, and complications of PFD compared with PFDD for the treatment of CM-I. Randomized or non-randomized controlled trials of PFD and PFDD were considered for inclusion...
June 1, 2016: Neurosurgical Review
Gaston O Camino Willhuber, Santiago T Bosio, Miguel H Puigdevall, Carolina Halliburton, Carlos A Sola, Ruben A Maenza
To present and describe an unusual case of spinal instability after craniocervical spinal decompression for a type-1 Chiari malformation. Type-1 Chiari malformation is a craniocervical disorder characterized by tonsillar displacement greater than 5 mm into the vertebral canal; posterior fossa decompression is the most common surgical treatment for this condition. Postoperative complications have been described: cerebrospinal fluid leak, pseudomeningocele, aseptic meningitis, wound infection, and neurological deficit...
June 2, 2016: Journal of Pediatric Orthopedics. Part B
M Cristina Victorio, Chaouki K Khoury
Headache is a common problem in children and adolescents. Its recurrent and disabling nature may lead to use of neuroimaging to exclude secondary causes of headache such as Chiari I malformation (CM I). CM I has a variety of presentation with headache being the most common symptom. CM I can be asymptomatic and is also often found incidentally in neuroimaging done for conditions other than headache. This article reviews the spectrum of headache in patients with CM I.
February 2016: Seminars in Pediatric Neurology
R Shane Tubbs, Christina M Kirkpatrick, Elias Rizk, Joshua J Chern, Rod J Oskouian, W Jerry Oakes
BACKGROUND: In the past, diagnosis of the Chiari I malformation has primarily been made on midsagittal MRI. We hypothesized that based on the frequent presentation of opisthotonos in patients with hindbrain hernia (primarily Chiari II malformation but sometimes Chiari I malformation) that the hyperextension might be a compensatory technique used by such patients to bring the cerebellar tonsils up out of the cervical spine. PATIENTS AND METHODS: This prospective study reviewed imaging of patients with Chiari I malformation who underwent flexion/extension MRI for evaluation of their hindbrain herniation...
March 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Ozan Alper Alkoç, Ahmet Songur, Olcay Eser, Muhsin Toktas, Yücel Gönül, Ertap Esi, Alpay Haktanir
OBJECTIVE: In this study, we aimed to investigate the underlying ethiological factors in chiari malformation (CM) type-I (CMI) via performing volumetric and morphometric length-angle measurements. METHODS: A total of 66 individuals [33 patients (20-65 years) with CMI and 33 control subjects] were included in this study. In sagittal MR images, tonsillar herniation length and concurrent anomalies were evaluated. Supratentorial, infratentorial, and total intracranial volumes were measured using Cavalieri method...
November 2015: Journal of Korean Neurosurgical Society
Liyong Sun, Stephan Emich, Wenzhuo Fu, Zan Chen, Wu Hao, Feng Ling, Fengzeng Jian
A retrocerebellar arachnoid cyst causing syringomyelia is extremely rare without tonsillar herniation. The authors present a 44-year-old woman with symptoms of foramen magnum compression and syringomyelia. Magnetic resonance imaging demonstrated a large retrocerebellar arachnoid cyst with a large cervicothoracic syrinx but no signs of tonsillar herniation or hydrocephalus. The patient underwent a foramen magnum decompression with C1 laminectomy, microsurgical fenestration of the cyst, and duraplasty. After successful reconstruction of CSF flow, the patient experienced a relief of symptoms and a significant reduction of the syrinx...
April 2016: Neurosurgical Review
Jian-Lan Zhao, Mei-Hua Li, Chun-Liang Wang, Wei Meng
OBJECTIVE: To elucidate the most efficacious treatments of Chiari I malformation (CIM). METHODS: A literature search was performed using PubMed, CINAHL/Ovid, Cochrane library, and the Elsevier database. The key words "Chiari I malformation," "Chiari malformation type I," "surgery," and "treatment" were used for the search. Articles had to be peer reviewed and provide primary outcomes measured by clinical and radiographic outcomes after surgical treatments. Exclusion criteria included non-English-language articles, case reports, commentaries, information from textbooks and expert opinions, and articles that did not provide outcomes concerning specific surgical methods...
April 2016: World Neurosurgery
Vannessa Leung, John S Magnussen, Marcus A Stoodley, Lynne E Bilston
OBJECTIVE: The pathogenesis of syringomyelia associated with Chiari malformation type I (CM-I) is unclear. Theories of pathogenesis suggest the cerebellar tonsils may obstruct CSF flow or alter pressure gradients, or their motion might act as a piston to increase CSF pressure in the spinal subarachnoid space. This study was performed to measure cerebellar tonsillar and hindbrain motion in CM-I and assess the potential contributions to syrinx formation. METHODS: Sixty-four CM-I patients and 25 controls were retrospectively selected from a clinical database, and all subjects had undergone cardiac-gated cine balanced fast-field echo MRI...
April 2016: Journal of Neurosurgery. Spine
Hannah E Goldstein, Richard C E Anderson
This article addresses the key features, clinical presentation, and radiographic findings associated with craniovertebral junction instability in the setting of Chiari I malformation. It further discusses surgical technique for treating patients with Chiari I malformation with concomitant craniovertebral junction instability, focusing on modern posterior rigid instrumentation and fusion techniques.
October 2015: Neurosurgery Clinics of North America
Soroush Heidari Pahlavian, Francis Loth, Mark Luciano, John Oshinski, Bryn A Martin
Central nervous system (CNS) tissue motion of the brain occurs over 30 million cardiac cycles per year due to intracranial pressure differences caused by the pulsatile blood flow and cerebrospinal fluid (CSF) motion within the intracranial space. This motion has been found to be elevated in type 1 Chiari malformation. The impact of CNS tissue motion on CSF dynamics was assessed using a moving-boundary computational fluid dynamics (CFD) model of the cervical-medullary junction (CMJ). The cerebellar tonsils and spinal cord were modeled as rigid surfaces moving in the caudocranial direction over the cardiac cycle...
December 2015: Annals of Biomedical Engineering
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