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The role of clivus length and cranial base flexion angle in basilar invagination and Chiari malformation pathophysiology.
Neurol Sci. 2020 Jul; 41(7):1751-1757.NS

Abstract

BACKGROUND

The craniovertebral junction is an anatomically well-defined transitional zone located between the skull and the cervical spine. Multiple malformations can affect this region with the most prominent being basilar invagination (BI) and Chiari malformation (CM). Despite numerous studies, the origin, pathophysiology, and classification of these pathologies remain controversial. The objective of this study was to evaluate the implication of cranial base flexion angle and clivus length in the development of these conditions.

METHODS

Midline tomography and magnetic resonance imaging of normal subjects and patients diagnosed with BI (types I and II) and Chiari malformation were evaluated. A craniometric study of the skull base was performed. Linear and angular measurements were used for comparisons between groups.

RESULTS

109 images from patients with craniovertebral junction malformation and controls were evaluated. Seventeen had BI-I, 26 had BI-II, 36 had CM, and 30 were normal subjects. Demographic data for the two groups were not significantly different. Craniometric analysis of images revealed a gradation in linear and angular variables from controls to CM, BI-I, and BI-II patients. Clivus length was significantly smaller in BI-II patients compared with other groups, while basal angle was greater. Moderate or strong correlations were noted among all variables analyzed.

CONCLUSION

Data suggest that clivus length and basal angle may play a role in pathophysiology of BI and CM.

Authors+Show Affiliations

Department of Neurosurgery, Hospital do Servidor Público Estadual - IAMSPE, São Paulo, Brazil.Department of Neurosurgery, Hospital do Servidor Público Estadual - IAMSPE, São Paulo, Brazil. bitbot@uol.com.br.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32002740

Citation

Diniz, Juliete M., and Ricardo V. Botelho. "The Role of Clivus Length and Cranial Base Flexion Angle in Basilar Invagination and Chiari Malformation Pathophysiology." Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, vol. 41, no. 7, 2020, pp. 1751-1757.
Diniz JM, Botelho RV. The role of clivus length and cranial base flexion angle in basilar invagination and Chiari malformation pathophysiology. Neurol Sci. 2020;41(7):1751-1757.
Diniz, J. M., & Botelho, R. V. (2020). The role of clivus length and cranial base flexion angle in basilar invagination and Chiari malformation pathophysiology. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 41(7), 1751-1757. https://doi.org/10.1007/s10072-020-04248-1
Diniz JM, Botelho RV. The Role of Clivus Length and Cranial Base Flexion Angle in Basilar Invagination and Chiari Malformation Pathophysiology. Neurol Sci. 2020;41(7):1751-1757. PubMed PMID: 32002740.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of clivus length and cranial base flexion angle in basilar invagination and Chiari malformation pathophysiology. AU - Diniz,Juliete M, AU - Botelho,Ricardo V, Y1 - 2020/01/30/ PY - 2019/09/19/received PY - 2020/01/09/accepted PY - 2020/2/1/pubmed PY - 2020/2/1/medline PY - 2020/2/1/entrez KW - Basal angle KW - Basilar invagination KW - Chiari malformation KW - Clivus SP - 1751 EP - 1757 JF - Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology JO - Neurol. Sci. VL - 41 IS - 7 N2 - BACKGROUND: The craniovertebral junction is an anatomically well-defined transitional zone located between the skull and the cervical spine. Multiple malformations can affect this region with the most prominent being basilar invagination (BI) and Chiari malformation (CM). Despite numerous studies, the origin, pathophysiology, and classification of these pathologies remain controversial. The objective of this study was to evaluate the implication of cranial base flexion angle and clivus length in the development of these conditions. METHODS: Midline tomography and magnetic resonance imaging of normal subjects and patients diagnosed with BI (types I and II) and Chiari malformation were evaluated. A craniometric study of the skull base was performed. Linear and angular measurements were used for comparisons between groups. RESULTS: 109 images from patients with craniovertebral junction malformation and controls were evaluated. Seventeen had BI-I, 26 had BI-II, 36 had CM, and 30 were normal subjects. Demographic data for the two groups were not significantly different. Craniometric analysis of images revealed a gradation in linear and angular variables from controls to CM, BI-I, and BI-II patients. Clivus length was significantly smaller in BI-II patients compared with other groups, while basal angle was greater. Moderate or strong correlations were noted among all variables analyzed. CONCLUSION: Data suggest that clivus length and basal angle may play a role in pathophysiology of BI and CM. SN - 1590-3478 UR - https://www.unboundmedicine.com/medline/citation/32002740/The_role_of_clivus_length_and_cranial_base_flexion_angle_in_basilar_invagination_and_Chiari_malformation_pathophysiology_ L2 - https://link.springer.com/10.1007/s10072-020-04248-1 DB - PRIME DP - Unbound Medicine ER -
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