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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 11; 163(11):3051-3064.AN

Abstract

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). Neurological examination data and MRI parameters were analyzed.

RESULTS

All patient cohorts had morphometric evidence of a small, flattened, and overcrowded PCF. The PCF phenotype of the SPCF-TH0-only group differed from that of other CM cohorts in that the length of clivus and supraocciput and the height of the PF were longer, the upper CSF spaces of PCF were taller, and the area of the foramen magnum was smaller. The SPCF-TH0 groups had a more significant narrowing of the superior cervical canal and a smaller decrease in PCF height than the SPCF-CM1 groups.

CONCLUSIONS

Patients with SPCF-TH0 with and without syringomyelia developed Chiari 1 symptoms and signs. Patients with SPCF-TH0-syr (Chiari 0) had more constriction of their CSF pathways in and around the foramen magnum than patients with SPCF-TH0-only.

Authors+Show Affiliations

Department of Neurology and Rehabilitation, Kazan State Medical University, Butlerov str. 49, Kazan, Russian Federation.Department of Neurology and Rehabilitation, Kazan State Medical University, Butlerov str. 49, Kazan, Russian Federation. aisluzab@mail.ru.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.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34448046

Citation

Bogdanov, Enver I., et al. "Posterior Cranial Fossa and Cervical Spine Morphometric Abnormalities in Symptomatic Chiari Type 0 and Chiari Type 1 Malformation Patients With and Without Syringomyelia." Acta Neurochirurgica, vol. 163, no. 11, 2021, pp. 3051-3064.
Bogdanov EI, Faizutdinova AT, Heiss JD. 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;163(11):3051-3064.
Bogdanov, E. I., Faizutdinova, A. T., & Heiss, J. D. (2021). Posterior cranial fossa and cervical spine morphometric abnormalities in symptomatic Chiari type 0 and Chiari type 1 malformation patients with and without syringomyelia. Acta Neurochirurgica, 163(11), 3051-3064. https://doi.org/10.1007/s00701-021-04941-w
Bogdanov EI, Faizutdinova AT, Heiss JD. 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;163(11):3051-3064. PubMed PMID: 34448046.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posterior cranial fossa and cervical spine morphometric abnormalities in symptomatic Chiari type 0 and Chiari type 1 malformation patients with and without syringomyelia. AU - Bogdanov,Enver I, AU - Faizutdinova,Aisylu T, AU - Heiss,John D, Y1 - 2021/08/27/ PY - 2021/04/09/received PY - 2021/07/03/accepted PY - 2021/8/28/pubmed PY - 2021/11/25/medline PY - 2021/8/27/entrez KW - Chiari malformation type 0 KW - Chiari malformation type 1 KW - Morphometric abnormalities KW - Posterior cranial fossa KW - Spinal canal KW - Syringomyelia SP - 3051 EP - 3064 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 163 IS - 11 N2 - 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). Neurological examination data and MRI parameters were analyzed. RESULTS: All patient cohorts had morphometric evidence of a small, flattened, and overcrowded PCF. The PCF phenotype of the SPCF-TH0-only group differed from that of other CM cohorts in that the length of clivus and supraocciput and the height of the PF were longer, the upper CSF spaces of PCF were taller, and the area of the foramen magnum was smaller. The SPCF-TH0 groups had a more significant narrowing of the superior cervical canal and a smaller decrease in PCF height than the SPCF-CM1 groups. CONCLUSIONS: Patients with SPCF-TH0 with and without syringomyelia developed Chiari 1 symptoms and signs. Patients with SPCF-TH0-syr (Chiari 0) had more constriction of their CSF pathways in and around the foramen magnum than patients with SPCF-TH0-only. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/34448046/Posterior_cranial_fossa_and_cervical_spine_morphometric_abnormalities_in_symptomatic_Chiari_type_0_and_Chiari_type_1_malformation_patients_with_and_without_syringomyelia_ L2 - https://dx.doi.org/10.1007/s00701-021-04941-w DB - PRIME DP - Unbound Medicine ER -