scholarly journals Tapering of the cervical spinal canal in patients with distended or non-distended syringes secondary to Chiari malformation type I

Scoliosis ◽  
2015 ◽  
Vol 10 (S1) ◽  
Author(s):  
Zezhang Zhu ◽  
Shifu Sha ◽  
Xu Sun ◽  
Zhen Liu ◽  
Huang Yan ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Chiari Malformation ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Cervical Spinal Canal

Association Between Resistance to Cerebrospinal Fluid Flow Near the Foramen Magnum and Cough-Associated Headache in Adult Chiari Malformation Type I

2021 ◽  
Author(s):  
Alaaddin Ibrahimy ◽  
Chi-Wen Christina Huang ◽  
Abraham F. Bezuidenhout ◽  
Phillip A. Allen ◽  
Rafeeque A. Bhadelia ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Roc Curve ◽  
Spinal Canal ◽  
Chiari Malformation ◽  
Foramen Magnum ◽  
Patient Specific ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Cerebrospinal Fluid Flow ◽  
Longitudinal Impedance

Abstract Background and Purpose: Cough-associated headaches (CAH) are thought to be distinctive for Chiari malformation type I (CMI) patients and have been shown to be related to the motion of cerebrospinal fluid (CSF) near the foramen magnum. We used computational fluid dynamics (CFD) to compute patient-specific resistance to CSF motion in the spinal canal for CMI patients to determine its accuracy in predicting CAH. Methods: 51 symptomatic CMI patients with cerebellar tonsillar position (CTP) = 5 mm were included in this study. The patients were divided into two groups based on their symptoms (CAH and non-CAH) by review of the neurosurgical records. CFD was utilized to simulate CSF motion and the integrated longitudinal impedance (ILI) was calculated for all patients. A receiver operating characteristic (ROC) curve was evaluated for its accuracy in predicting CAH. Results: The ILI for CMI patients with CAH (776 dyn/cm5, 288-1444 dyn/cm5; median, inter-quartile range) was significantly larger compared to non-CAH (285 dyn/cm5, 187-450 dyn/cm5; p = .001). The ILI was more accurate in predicting CAH in CMI patients than the CTP when the comparison was made using the area under the ROC curve (0.77 and 0.70, for ILI and CTP, respectively). ILI = 750 dyn/cm5 had a sensitivity of 50% and a specificity of 95% in predicting CAH. Conclusions: ILI is a parameter, used to assess CSF blockage in the spinal canal and can predict patients with and without CAH with greater accuracy than CTP.

Prognostic significance of C1–C2 facet malalignment after surgical decompression in adult Chiari malformation type I: a pilot study based on the Chicago Chiari Outcome Scale

2020 ◽  
pp. 1-7
Author(s):  
Michael Lumintang Loe ◽  
Tito Vivas-Buitrago ◽  
Ricardo A. Domingo ◽  
Johan Heemskerk ◽  
Shashwat Tripathi ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chiari Malformation ◽  
Prognostic Significance ◽  
Foramen Magnum ◽  
Bivariate Analysis ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Swallowing Function ◽  
Chiari Malformation Type I

OBJECTIVEThe authors assessed the prognostic significance of various clinical and radiographic characteristics, including C1–C2 facet malalignment, in terms of surgical outcomes after foramen magnum decompression of adult Chiari malformation type I.METHODSThe electronic medical records of 273 symptomatic patients with Chiari malformation type I who were treated with foramen magnum decompression, C1 laminectomy, and duraplasty at Mayo Clinic were retrospectively reviewed. Preoperative and postoperative Neurological Scoring System scores were compared using the Friedman test. Bivariate analysis was conducted to identify the preoperative variables that correlated with the patient Chicago Chiari Outcome Scale (CCOS) scores. Multiple linear regression analysis was subsequently performed using the variables with p < 0.05 on the bivariate analysis to check for independent associations with the outcome measures. Statistical software SPSS version 25.0 was used for the data analysis. Significance was defined as p < 0.05 for all analyses.RESULTSFifty-two adult patients with preoperative clinical and radiological data and a minimum follow-up of 12 months were included. Motor deficits, syrinx, and C1–C2 facet malalignment were found to have significant negative associations with the CCOS score at the 1- to 3-month follow-up (p < 0.05), while at the 9- to 12-month follow-up only swallowing function and C1–C2 facet malalignment were significantly associated with the CCOS score (p < 0.05). Multivariate analysis showed that syrinx presence and C1–C2 facet malalignment were independently associated with the CCOS score at the 1- to 3-month follow-up. Swallowing function and C1–C2 facet malalignment were found to be independently associated with the CCOS score at the 9- to 12-month follow-up.CONCLUSIONSThe observed results in this pilot study suggest a significant negative correlation between C1–C2 facet malalignment and clinical outcomes evaluated by the CCOS score at 1–3 months and 9–12 months postoperatively. Prospective studies are needed to further validate the prognostic value of C1–C2 facet malalignment and the potential role of atlantoaxial fixation as part of the treatment.

Regional Brain Tissue Displacement and Strain is Elevated in Subjects with Chiari Malformation Type I Compared to Healthy Controls: A Study Using DENSE MRI

2021 ◽  
Author(s):  
Blaise Simplice Talla Nwotchouang ◽  
Maggie S. Eppelheimer ◽  
Soroush Heidari Pahlavian ◽  
Jack W. Barrow ◽  
Daniel L. Barrow ◽  
...  
Keyword(s):  
Brain Tissue ◽  
Chiari Malformation ◽  
Type I ◽  
Healthy Controls ◽  
Chiari Malformation Type I ◽  
Regional Brain

Updated Evidence Regarding Chiari Malformation Type I and Management Options

2020 ◽  
Vol 42 (5) ◽  
pp. 1-5
Author(s):  
Jeffrey Hatef ◽  
Eric A. Sribnick ◽  
Jeffrey R. Leonard
Keyword(s):  
Chiari Malformation ◽  
Type I ◽  
Management Options ◽  
Chiari Malformation Type I

scholarly journals Sleep Disordered Breathing in Children and Adolescents with Chiari Malformation Type I

2013 ◽  
Vol 09 (04) ◽  
pp. 371-377 ◽  
Author(s):  
Anna Losurdo ◽  
Serena Dittoni ◽  
Elisa Testani ◽  
Chiara Di Blasi ◽  
Emanuele Scarano ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Chiari Malformation ◽  
Sleep Disordered Breathing ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Disordered Breathing

scholarly journals Standard and cardiac-gated phase-contrast magnetic resonance imaging in the clinical course of patients with Chiari malformation Type I

2011 ◽  
Vol 31 (3) ◽  
pp. E5 ◽  
Author(s):  
Uwe Max Mauer ◽  
Andreas Gottschalk ◽  
Carolin Mueller ◽  
Linda Weselek ◽  
Ulrich Kunz ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Chiari Malformation ◽  
Phase Contrast ◽  
Foramen Magnum ◽  
Central Canal ◽  
Type I ◽  
Csf Flow ◽  
Chiari Malformation Type I ◽  
Cerebrospinal Fluid Flow ◽  
Contrast Magnetic Resonance

Object The causal treatment of Chiari malformation Type I (CM-I) consists of removing the obstruction of CSF flow at the level of the foramen magnum. Cerebrospinal fluid flow can be visualized using dynamic phase-contrast MR imaging. Because there is only a paucity of studies evaluating CSF dynamics in the region of the spinal canal on the basis of preoperative and postoperative measurements, the authors investigated the clinical usefulness of cardiacgated phase-contrast MR imaging in patients with CM-I. Methods Ninety patients with CM-I underwent preoperative MR imaging of CSF pulsation. Syringomyelia was present in 59 patients and absent in 31 patients. Phase-contrast MR imaging of the entire CNS was used to investigate 22 patients with CM-I before surgery and after a mean postoperative period of 12 months (median 12 months, range 3–33 months). In addition to the dynamic studies, absolute flow velocities, the extension of the syrinx, and tonsillar descent were also measured. Results The changes in pulsation were highly significant in the region of the (enlarged) cistern (p = 0.0005). Maximum and minimum velocities (the pulsation amplitude) increased considerably in the region where the syrinx was largest in diameter. The changes of pulsation in these patients were significant in the subarachnoid space in all spinal segments but not in the syrinx itself and in the central canal. Conclusions The demonstration of CSF flow pulsation can contribute to assessments of surgical outcomes. The results presented here, however, raise doubts about current theories on the pathogenesis of syringomyelia.

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