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Effect of craniocervical decompression on peak CSF velocities in symptomatic patients with Chiari I malformation.
AJNR Am J Neuroradiol. 2004 Jan; 25(1):142-5.AA

Abstract

BACKGROUND AND PURPOSE

Peak CSF velocities detected in individual voxels in the subarachnoid space in patients with Chiari I malformations exceed those in similar locations in the subarachnoid space in healthy subjects. The purpose of this study was to test the hypothesis that the peak voxel velocities are decreased by craniocervical decompression.

METHODS

A consecutive series of patients with symptomatic Chiari I malformations was studied before and after craniocervical decompression with cardiac-gated, phase contrast MR imaging. Velocities were calculated for each voxel within the foramen magnum at 14 time points throughout the cardiac cycle. The greatest velocities measured in a voxel during the cephalad and caudad phases of CSF flow through the foramen magnum were tabulated for each patient before and after surgery. The differences in these velocities between the preoperative and postoperative studies were tested for statistical significance by using a single-tailed Student's t test of paired samples.

RESULTS

Eight patients with a Chiari I malformation, including four with a syrinx, were studied. Peak caudad velocity diminished after craniocervical decompression in six of the eight patients, and the average diminished significantly from 3.4 cm/s preoperatively to 2.4 cm/s postoperatively (P =.01). Peak cephalad velocity diminished in six of the eight cases. The average diminished from 6.9 cm/s preoperatively to 3.9 cm/s postoperatively, a change that nearly reached the significance level of.05 (P =.055).

CONCLUSION

Craniocervical decompression in patients with Chiari I malformations decreases peak CSF velocities in the foramen magnum. The study supports the hypothesis that successful treatment of the Chiari I malformation is associated with improvement in CSF flow patterns.

Authors+Show Affiliations

Department of Radiology, University of Wisconsin, Madison, WI, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

14729545

Citation

Dolar, Maria T., et al. "Effect of Craniocervical Decompression On Peak CSF Velocities in Symptomatic Patients With Chiari I Malformation." AJNR. American Journal of Neuroradiology, vol. 25, no. 1, 2004, pp. 142-5.
Dolar MT, Haughton VM, Iskandar BJ, et al. Effect of craniocervical decompression on peak CSF velocities in symptomatic patients with Chiari I malformation. AJNR Am J Neuroradiol. 2004;25(1):142-5.
Dolar, M. T., Haughton, V. M., Iskandar, B. J., & Quigley, M. (2004). Effect of craniocervical decompression on peak CSF velocities in symptomatic patients with Chiari I malformation. AJNR. American Journal of Neuroradiology, 25(1), 142-5.
Dolar MT, et al. Effect of Craniocervical Decompression On Peak CSF Velocities in Symptomatic Patients With Chiari I Malformation. AJNR Am J Neuroradiol. 2004;25(1):142-5. PubMed PMID: 14729545.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of craniocervical decompression on peak CSF velocities in symptomatic patients with Chiari I malformation. AU - Dolar,Maria T, AU - Haughton,Victor M, AU - Iskandar,Bermans J, AU - Quigley,Mark, PY - 2004/1/20/pubmed PY - 2004/4/28/medline PY - 2004/1/20/entrez SP - 142 EP - 5 JF - AJNR. American journal of neuroradiology JO - AJNR Am J Neuroradiol VL - 25 IS - 1 N2 - BACKGROUND AND PURPOSE: Peak CSF velocities detected in individual voxels in the subarachnoid space in patients with Chiari I malformations exceed those in similar locations in the subarachnoid space in healthy subjects. The purpose of this study was to test the hypothesis that the peak voxel velocities are decreased by craniocervical decompression. METHODS: A consecutive series of patients with symptomatic Chiari I malformations was studied before and after craniocervical decompression with cardiac-gated, phase contrast MR imaging. Velocities were calculated for each voxel within the foramen magnum at 14 time points throughout the cardiac cycle. The greatest velocities measured in a voxel during the cephalad and caudad phases of CSF flow through the foramen magnum were tabulated for each patient before and after surgery. The differences in these velocities between the preoperative and postoperative studies were tested for statistical significance by using a single-tailed Student's t test of paired samples. RESULTS: Eight patients with a Chiari I malformation, including four with a syrinx, were studied. Peak caudad velocity diminished after craniocervical decompression in six of the eight patients, and the average diminished significantly from 3.4 cm/s preoperatively to 2.4 cm/s postoperatively (P =.01). Peak cephalad velocity diminished in six of the eight cases. The average diminished from 6.9 cm/s preoperatively to 3.9 cm/s postoperatively, a change that nearly reached the significance level of.05 (P =.055). CONCLUSION: Craniocervical decompression in patients with Chiari I malformations decreases peak CSF velocities in the foramen magnum. The study supports the hypothesis that successful treatment of the Chiari I malformation is associated with improvement in CSF flow patterns. SN - 0195-6108 UR - https://www.unboundmedicine.com/medline/citation/14729545/Effect_of_craniocervical_decompression_on_peak_CSF_velocities_in_symptomatic_patients_with_Chiari_I_malformation_ L2 - http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=14729545 DB - PRIME DP - Unbound Medicine ER -