5,150 results match your criteria chiari malformation


[Effects of age and gender on posterior cranial fossa linear volume and cerebellar tonsil position in normal populations].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Sep;35(9):1167-1171

Department of Orthopedics, the Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China.

Objective: To investigate the effects of gender and age on the posterior cranial fossa linear volume and cerebellar tonsil position in normal populations.

Methods: A total of 180 normal adults who underwent cervical MRI examination at the physical examination center were selected, including 90 males and 90 females; the age ranged from 20 to 79 years, with an average of 50.4 years. Read More

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September 2021

Neonatal hydrocephalus: an atypical presentation of malignant infantile osteopetrosis.

Childs Nerv Syst 2021 Sep 14. Epub 2021 Sep 14.

Department of Neurological Surgery and Pediatrics, St. Louis Children's Hospital, Washington University in St. Louis, Saint Louis, MO, USA.

Purpose: Autosomal recessive osteopetrosis has a variable presentation, most commonly including failure to thrive, hypocalcemia, seizures, hepatosplenomegaly, hydrocephalus, vision or hearing loss, and cytopenias. Multiple symptoms are usually seen at presentation. The variability of presentation often delays diagnosis and subsequent treatment. Read More

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September 2021

Arnold-Chiari Malformation: Core Concepts.

Neonatal Netw 2021 Aug;40(5):313-320

Arnold-Chiari malformation (ACM), a defect that involves downward displacement of the hindbrain and herniation of the cerebellar vermis, tonsils, pons, medulla, and fourth ventricle through the foramen magnum, is the most complex of the 4 types of Chiari malformations. Unique to the other types of Chiari malformations, approximately 95 percent of infants with ACM also present with an associated myelomeningocele (MMC), the most severe form of spina bifida. Among affected infants, those with symptomatic comorbidities incur a significantly higher morbidity and mortality risk. Read More

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Foramen Magnum Decompression in Hemifacial Spasm Associated with Chiari 1 Malformation.

Neurol India 2021 Jul-Aug;69(4):1063-1064

Department of Neurosurgery, Government Medical College and Hospital, Trivandrum, Kerala, India.

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September 2021

Recurrent stridor in an infant.

BMJ Case Rep 2021 Sep 7;14(9). Epub 2021 Sep 7.

Department of Otorhinolaryngology, University of Malaya, Faculty of Medicine, Kuala Lumpur, WP Kuala Lumpur, Malaysia.

Paediatric upper airway obstruction is an emergency that requires immediate intervention. Among the myriad factors that leads to upper airway obstruction in paediatric age group, bilateral vocal cord palsy is not commonly encountered in clinical practice. The underlying cause of bilateral vocal cord palsy requires thorough investigation prior to deciding on the appropriate intervention. Read More

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September 2021

[Vertical nystagmus].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(8):119-124

Sverzhevskiy Otorhinolaryngology Healthcare Research Institute, Moscow, Russia.

The review article provides a definition and classification of different nystagmus types, a comparative description of the central and peripheral vestibular nystagmus. The pathogenetic patterns of up-beating and down-beating nystagmus are accurately described. The features of nystagmus formation in various diseases are discussed, such as Wernicke encephalopathy, Arnold-Chiari anomaly, spinocerebellar ataxia and vestibular migraine. Read More

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September 2021

Longitudinal scoliosis behavior in Chiari malformation with and without syringomyelia.

J Neurosurg Pediatr 2021 Sep 3:1-7. Epub 2021 Sep 3.

5Department of Neurosurgery, Washington University, St. Louis, Missouri.

Objective: The objective of this study was to understand the natural history of scoliosis in patients with Chiari malformation type I (CM-I) with and without syringomyelia.

Methods: A retrospective review of data was conducted. Patients with CM-I were identified from a cohort of 14,118 individuals age 18 years or younger who had undergone MRI over an 11-year period at the University of Michigan. Read More

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September 2021

Superficial siderosis associated with an iatrogenic posterior fossa dural leak identified on CT cisternography.

Neuroradiol J 2021 Sep 3:19714009211042875. Epub 2021 Sep 3.

Department of Neurology, Mayo Clinic, USA.

Superficial siderosis refers to hemosiderin deposition along the pial surface of the brain and spinal cord. It results from chronic and repetitive low-grade bleeding into the subarachnoid space. Dural tears are a common cause of superficial siderosis. Read More

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September 2021

Chiari Malformation: An Unhelpful Eponym.

World Neurosurg 2021 Aug 28;156:1-3. Epub 2021 Aug 28.

Cromwell Hospital, London, England. Electronic address:

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Atypical idiopathic intracranial hypertension presenting as cyclic vomiting syndrome: a case report.

J Med Case Rep 2021 Aug 31;15(1):440. Epub 2021 Aug 31.

Department of Neurology, Children's Memorial Hermann Hospital, 6410 Fannin St., Ste 1014, Houston, TX, 77030, USA.

Background: Idiopathic intracranial hypertension is a disorder of increased intracranial pressure in the absence of cerebrospinal outflow obstruction, mass lesion, or other underlying cause. It is a rare phenomenon in prepubertal children and is most typically found in women of childbearing age. The classic presentation consists of headaches, nausea, vomiting, and visual changes; however, children present more atypically. Read More

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Ventral Tonsillar Herniation Predicts Headaches in Adults with Chiari Malformation.

World Neurosurg 2021 Aug 26. Epub 2021 Aug 26.

Department of Neurological Surgery, Weill Cornell Medicine/NewYork Presbyterian Hospital, New York, New York. Electronic address:

Background: Radiographic characterization of Chiari malformation (CM) has historically focused on caudal tonsillar herniation (CH) below the foramen magnum. Previously, we published evidence linking ventral tonsillar herniation (VH) and medullary symptoms in very young children. We sought to extend that investigation by studying the radiographic and clinical significance of VH in adults diagnosed with CM. Read More

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Acquired cervical scoliosis in two dogs with inflammatory central nervous system disease.

J Vet Intern Med 2021 Aug 27. Epub 2021 Aug 27.

Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom.

Acquired cervical scoliosis previously has been reported in dogs as a clinical sign associated with Chiari-like malformation and syringomyelia but has not been described with inflammatory central nervous system disease. A 9-month-old Flat-Coated Retriever was presented with an acute onset of cervical scoliosis with no other neurological deficits. Magnetic resonance imaging identified a focal, poorly defined intramedullary lesion within the cranial cervical spinal cord. Read More

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Posterior cranial fossa and cervical spine morphometric abnormalities in symptomatic Chiari type 0 and Chiari type 1 malformation patients with and without syringomyelia.

Acta Neurochir (Wien) 2021 Aug 27. Epub 2021 Aug 27.

Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, 10-3D20, MSC-1414, Bethesda, MD, 20892-1414, USA.

Background: To better understand how anatomical features of Chiari malformation type 0 (CM0) result in the manifestation of Chiari malformation type 1 (CM1) signs and symptoms, we conducted a morphometric study of the posterior cranial fossa (PCF) and cervical canal in patients with CM1 and CM0.

Methods: This retrospective study had a STROBE design and included 120 adult patients with MRI evidence of a small PCF (SPCF), typical clinical symptoms of CM1, and a diagnosis of CM1, CM0, or SPCF-TH0-only (SPCF with cerebellar ectopia less than 2 mm and without syringomyelia). Patients were divided by MRI findings into 4 groups: SPCF-TH0-only, SPCF-TH0-syr (CM0 with SPCF and syringomyelia), SPCF-CM1-only (SPCF with cerebellar ectopia 5 mm or more without syringomyelia), and SPCF-CM1-syr (CM1 with syringomyelia). Read More

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Multi-parameter-based radiological diagnosis of Chiari Malformation using Machine Learning Technology.

Int J Clin Pract 2021 Aug 24:e14746. Epub 2021 Aug 24.

Department of Radiology, Inonu University School of Medicine, Malatya, Turkey.

Background: The known primary radiological diagnosis of Chiari Malformation-I (CM-I) is based on the degree of tonsillar herniation (TH) below the Foramen Magnum (FM). However, recent data also shows the association of such malformation with smaller posterior cranial fossa (PCF) volume and the anatomical issues regarding the Odontoid. This study presents the achieved result regarding some detected potential radiological findings that may aid CM-I diagnosis using several machine learning (ML) algorithms. Read More

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Diagnostic utility of parasagittal measurements of tonsillar herniation in Chiari I malformation.

Neuroradiol J 2021 Aug 24:19714009211041524. Epub 2021 Aug 24.

Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, USA.

Background And Purpose: Although the cerebellar tonsils are parasagittal structures, the extent of tonsillar herniation (ETH) in Chiari I malformation (CMI) is currently measured in the midsagittal plane. We measured the ETH of each cerebellar tonsil in the parasagittal plane and assessed their diagnostic utility by comparing them to the midsagittal ETH measurements in predicting cough-associated headache (CAH), an indicator of clinically significant disease in CMI.

Methods: Eighty-five CMI patients with 3D-MPRAGE images were included. Read More

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Standardizing postoperative care for pediatric intradural Chiari decompressions to decrease length of stay.

J Neurosurg Pediatr 2021 Aug 20:1-6. Epub 2021 Aug 20.

Objective: Amid national and local budget crises, cutting costs while maintaining quality care is a top priority. Chiari malformation is a relatively common pediatric neurosurgical pathology, and postoperative care varies widely. The postoperative course can be complicated by pain and nausea, which can extend the hospital stay. Read More

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Entire-spine Magnetic Resonance Imaging Findings and Costs in Children With Presumed Adolescent Idiopathic Scoliosis.

J Pediatr Orthop 2021 Aug 19. Epub 2021 Aug 19.

Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA.

Background: Patients with adolescent idiopathic scoliosis (AIS) are commonly monitored for curve progression with spinal radiographs; however, the utility of magnetic resonance imaging (MRI) screening is unclear. The purpose of this study was to assess the findings of screening MRI for patients with a nonsurgical curve size ordered during routine clinical care and compare them with MRI ordered for patients with large curves as part of preoperative screening.

Methods: All consecutive patients with presumed AIS who underwent entire-spine MRI with a presumed diagnosis of idiopathic scoliosis at a single institution between 2017 and 2019 were retrospectively reviewed. Read More

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Brace treatment for scoliosis secondary to chiari malformation type 1 or syringomyelia without neurosurgical intervention: A matched comparison with idiopathic scoliosis.

Eur Spine J 2021 Aug 19. Epub 2021 Aug 19.

Spine Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.

Purpose: To evaluate the effectiveness of brace treatment in patients with Chiari malformation type 1 (CM-1) or syringomyelia associated scoliosis without neurosurgical intervention.

Methods: This was a retrospective case-control study. 34 CM-1 or syringomyelia (CMS) patients who received brace treatment without neurosurgical intervention were recruited. Read More

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Venous anomalies in hypoplastic posterior fossa: unsolved questions.

Childs Nerv Syst 2021 Aug 18. Epub 2021 Aug 18.

Department of Medical Genetics, Fernandes Figueira National Institute of Health for Women, Children and Adolescents , Oswaldo Cruz Foundation (IFFFiocruz), Rio de Janeiro, Brazil.

Introduction: Anomalous intracranial venous anatomy is described in patients with syndromic craniosynostosis and is of significant importance when it comes to surgical morbidity. However, it is still controversial its origin, type of circulation in each syndrome, how it behaves over time, when it can be interrupted and wether it needs to be studied. The purpose of this paper is to discuss these issues by reviewing the literature. Read More

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Endoscopic Endonasal Resection of Cranio-Cervical Junction Chordoma and Ventral Chiari Decompression: A Case Report.

Oper Neurosurg (Hagerstown) 2021 Aug 14. Epub 2021 Aug 14.

Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Background: Chiari I malformations secondary to other causes represent a small subset of presenting symptomatic cases. Typically, the primary cause of the malformation is addressed first and results in resolution of the malformation and symptoms. However, in some cases, a patient may present with both a primary Chiari I malformation and another unrelated neurosurgical lesions. Read More

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Hydrocephalus and occipital encephaloceles: presentation of a series and review of the literature.

Childs Nerv Syst 2021 Aug 14. Epub 2021 Aug 14.

Department of Pediatric Surgery, Division of Pediatric Neurosurgery, Figueira National Institute of Health for Women, Children and Adolescents, Oswaldo Cruz Foundation (IFF-Fiocruz), Rio de Janeiro, Brazil.

Introduction: Encephaloceles are rare congenital malformations of the central nervous system in which brain tissue is extruded from a defect in the skull. Hydrocephalus can occur in 60 to 90% of patients with posterior encephaloceles when compared to other types of this malformation. This article aims to present a series of posterior encephaloceles and its association with hydrocephalus as well as promote a review of the pertinent literature. Read More

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CSF-space volumetric change following posterior fossa decompression in paediatric Chiari type-I malformation: a correlation with outcome.

Childs Nerv Syst 2021 Aug 14. Epub 2021 Aug 14.

School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4029, Australia.

Objective: We have previously reported inferior post-operative clinical outcomes in younger children with Chiari type-I malformation (CIM). We sought to quantify the CSF volumetric changes pre- and post-decompression, in a paediatric cohort, to determine whether cisternal volume change is associated with clinical outcomes.

Methods: In this retrospective clinical study, the CSF spaces of the posterior fossa (supracerebellar/quadrigeminal, prepontine, fourth ventricle, cisterna magna) were measured on magnetic resonance images pre- and post-operatively using a semi-automated method. Read More

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Craniospinal subdural hygroma postdecompression for Chiari malformation: the slit valve mechanism.

BMJ Case Rep 2021 Aug 11;14(8). Epub 2021 Aug 11.

Alfaisal University College of Medicine, Riyadh, Saudi Arabia

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Impact of Brain Malformations on Neurodevelopmental Outcome in Children with a History of Prenatal Surgery for Open Spina Bifida.

Fetal Diagn Ther 2021 Aug 11:1-8. Epub 2021 Aug 11.

Zurich Center for Spina Bifida, University Children's Hospital Zurich, Zurich, Switzerland.

Introduction: This retrospective study investigates brain malformations and their impact on neurodevelopmental outcome in children after prenatal surgery for spina bifida (SB).

Methods: Sixty-one patients were included. On neonatal MRI, SB-associated brain malformations were assessed. Read More

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A case series of hypersensitivity reactions to ventriculoperitoneal shunt material.

J Clin Neurosci 2021 Sep 2;91:84-87. Epub 2021 Jul 2.

Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Medical Center, Montefiore Hospital, NW628, 3459 Fifth Avenue, Pittsburgh, PA 15213, United States. Electronic address:

Hypersensitivity reactions to ventriculoperitoneal (VP) or lumboperitoneal (LP) shunts are rare. Symptoms often resolve following shunt replacement with a silicone-free hypoallergenic shunt. We describe novel cases of allergies to both standard and hypoallergenic shunts and highlight the utility of patch testing. Read More

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September 2021

Complex Chiari Malformation: Proposal of a New Set of Diagnostic Criteria and Outcomes After fusion Surgery.

World Neurosurg 2021 Jul 31. Epub 2021 Jul 31.

Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India.

Background: The proposal of C1-C2 fusion as a better treatment option compared with foramen magnum decompression (FMD) for the treatment of Chiari 1 malformations has led to controversy. Although FMD is a time-tested treatment option, a group of patients exists who will benefit from C1-C2 fusion. We have proposed an objective system for defining complex Chiari malformations and studied the outcomes of fusion with decompression versus decompression alone for these patients. Read More

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State of the art in translating experimental myelomeningocele research to the bedside.

Childs Nerv Syst 2021 09 31;37(9):2769-2785. Epub 2021 Jul 31.

Division of Pediatric Neurosurgery - Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Myelomeningocele (MMC), the commonest type of spina bifida (SB), occurs due to abnormal development of the neural tube and manifest as failure of the complete fusion of posterior arches of the spinal column, leading to dysplastic growth of the spinal cord and meninges. It is associated with several degrees of motor and sensory deficits below the level of the lesion, as well as skeletal deformities, bladder and bowel incontinence, and sexual dysfunction. These children might develop varying degrees of neuropsychomotor delay, partly due to the severity of the injuries that affect the nervous system before birth, partly due to the related cerebral malformations (notably hydrocephalus-which may also lead to an increase in intracranial pressure-and Chiari II deformity). Read More

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September 2021

The "Three on a Stick" Incision-A Curvilinear Solution for the Occipital and Suboccipital Region.

Oper Neurosurg (Hagerstown) 2021 Sep;21(4):235-241

Division of Neurosurgery, Schneider Children's Medical Center of Israel, Clalit Health System, Petah Tikva, Israel.

Background: Different conditions of the posterior fossa such as Chiari malformations, tumors, and arachnoid cysts require surgery through a suboccipital approach, for which a typical midline vertical linear incision is used. Curvilinear incisions have been carried in all other scalp regions other than the sub region for better cosmetic outcomes; a vertical curvilinear incision in the occipital and suboccipital region has not been reported.

Objective: To evaluate the cosmetic value and safety of the "3 on a stick" vertical suboccipital curvilinear incision. Read More

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September 2021

Neurofluids-Deep inspiration, cilia and preloading of the astrocytic network.

J Neurosci Res 2021 Jul 29. Epub 2021 Jul 29.

Division of Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany.

With the advent of real-time MRI, the motion and passage of cerebrospinal fluid can be visualized without gating and exclusion of low-frequency waves. This imaging modality gives insights into low-volume, rapidly oscillating cardiac-driven movement as well as sustained, high-volume, slowly oscillating inspiration-driven movement. Inspiration means a spontaneous or artificial increase in the intrathoracic dimensions independent of body position. Read More

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"Motion-specific Headache": A Predictor for Diagnosis and Favorable Prognosis after Surgery in Young Patients with Chiari Malformation Type 1.

Neurol Med Chir (Tokyo) 2021 Jul 27. Epub 2021 Jul 27.

Department of Neurosurgery, Kurume University School of Medicine.

As headache is known as one of the most common symptoms in the patients with Chiari malformation type 1 (CM1), it is difficult to find out CM1-related headache among the symptoms because headache itself is commonly seen. Herein, we retrospectively review the cases of six CM1 patients complaining only of headache by which they complained of deterioration in daily life activities. The symptom of headache worsened during anteflexion (n = 2; 33%), retroflexion (n = 1; 17%), jumping (n = 3; 50%), going up the stairs (n = 1; 17%), and running (n = 1; 17%). Read More

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