Article
Clinical Neurology
John K. Chae, Arsalan Haghdel, Alexander Kelly, Amanda Cruz, Myles Wood, Grant Luhmann, Jeffrey P. Greenfield
Summary: The study found that VH is relatively common in CM patients and might be an important independent radiographic metric to evaluate and consider, especially in those presenting with Chiari-like symptomatology referable to the medulla but who do not meet the traditional criteria of cerebellar ectopia greater than 5 mm.
WORLD NEUROSURGERY
(2021)
Article
Medicine, General & Internal
Rachel J. Park, Sunil Unnikrishnan, Joel Berliner, John Magnussen, Shinuo Liu, Marcus A. Stoodley
Summary: Chiari I malformation is defined as the descent of the cerebellar tonsils below the foramen magnum by more than 5 mm. Suboccipital decompression is the main treatment option for symptomatic patients. However, there are other conditions that can mimic the imaging features of Chiari I malformation, putting these patients at risk of misdiagnosis and unnecessary surgery. This study aims to identify differentiating imaging features of Chiari I malformation mimics, such as post-traumatic cranio-cervical junction arachnoiditis, dural bands, spontaneous intracranial hypotension, idiopathic intracranial hypertension, and cysts.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Anatomy & Morphology
N. Boggio, M. Mathkour, L. Olewnik, J. Iwanaga, C. J. Bui, E. E. Biro, R. S. Tubbs
Summary: We report a rare case of Chiari I malformation with a bihemispheric posterior inferior cerebellar artery (PICA). This vascular variation should be taken into consideration during posterior fossa decompression for symptomatic Chiari I malformation to avoid catastrophic consequences that could arise from unilateral PICA injury.
FOLIA MORPHOLOGICA
(2023)
Review
Medicine, General & Internal
Enver Bogdanov, Aisylu T. Faizutdinova, John D. Heiss
Summary: Patients with typical CM1 symptoms usually undergo MRI, and a TH of more than 5 mm is diagnosed as CM1, a TH between 3-5 mm is diagnosed as borderline CM1, and a TH of less than 3 mm with an associated cervical syrinx is diagnosed as CM0. However, patients are usually not diagnosed with CM if MRI shows less than 3-5 mm of TH and no syrinx. Recent MRI morphometric analysis has detected anatomical abnormalities that explain these symptoms.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Otorhinolaryngology
Inbal Hazkani, Courtney Voyles, Kartik M. Reddy, Adina Alazraki, Nikhila Raol
Summary: This study evaluated the prevalence of Chiari malformation and tonsillar ectopia in children with dysphagia using brain magnetic resonance imaging. The results showed a relatively high prevalence of tonsillar ectopia in these patients. Therefore, brain MRI should be performed in pediatric patients with persistent dysphagia.
AMERICAN JOURNAL OF OTOLARYNGOLOGY
(2023)
Review
Medicine, General & Internal
Juan Sahuquillo, Dulce Moncho, Alex Ferre, Diego Lopez-Bermeo, Aasma Sahuquillo-Muxi, Maria A. Poca
Summary: This review examines different classification approaches for Chiari malformations and proposes a simplified scheme to differentiate between various types of tonsillar herniations. It also explores the most appropriate terminology for acquired herniation of cerebellar tonsils and other secondary Chiari-like malformations. This paper contributes to the ongoing discussion by offering insights into the evolving understanding of Chiari malformations and proposing a simplified classification and terminology system for diagnosis and management.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Neurosciences
Himanshu Sharma, Jeffrey M. Treiber, David F. Bauer
Summary: Chiari 1 malformation, characterized by caudal cerebellar tonsillar displacement, can have varied clinical outcomes, including life-threatening hydrocephalus. Understanding the pathophysiological processes underlying the development of hydrocephalus in these patients is critical for effective management. Current scientific thinking on Chiari 1 malformations and operative management can be unified to develop a structured approach to diagnosis and management of Chiari 1-associated hydrocephalus.
Article
Clinical Neurology
Seyed Amir Ebrahimzadeh, Elizabeth Du, Yu-Ming Chang, Marc Bouffard, Francis Loth, Rafeeque A. Bhadelia
Summary: This study aimed to identify imaging findings that could distinguish between patients with idiopathic intracranial hypertension (IIH) and cerebellar tonsillar herniation >= 5 mm, mimicking Chiari malformation I (CMI). The presence of bilateral transverse sinus stenosis (BTSS) and/or hypophysis-sella ratio (HSR) < 0.5 in patients with tonsillar herniation >= 5 mm should prompt further evaluation to exclude IIH before considering CMI surgery.
Article
Clinical Neurology
Jessica L. Houk, Timothy J. Amrhein, Linda Gray, Michael D. Malinzak, Peter G. Kranz
Summary: This study aimed to explore whether objective measurements of midbrain morphology could differentiate CM-1 from SIH. The results showed that measurements of midbrain sagging could effectively distinguish between these two conditions, which is important for avoiding misdiagnosis and unnecessary surgery.
JOURNAL OF NEUROSURGERY
(2022)
Article
Multidisciplinary Sciences
Tommy Lik Hang Chan, Kiven Vuong, Tara Chugh, Ian Carroll
Summary: Cerebellar tonsillar descent seen on imaging can lead to misdiagnosis of Chiari malformation type 1 in patients with spinal cerebrospinal fluid leak, potentially resulting in unnecessary surgeries instead of less invasive treatments such as epidural blood patches. Clinical-radiological correlation is crucial in considering a spinal cerebrospinal fluid leak in the differential diagnosis.
Article
Surgery
Bianca K. den Ottelander, Marjolein H. G. Dremmen, Catherine A. de Planque, Mark J. W. van der Oest, Irene M. J. Mathijssen, Marie-Lise C. Van Veelen
Summary: This study evaluated the association between skull base deformities and cerebellar tonsillar herniation in patients with syndromic craniosynostosis, finding significant differences in skull base structure at birth and its relationship to cerebellar tonsillar position in various syndromes.
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
(2022)
Article
Medicine, General & Internal
Ming Yang, Hai-Tao Niu, Hong-Sheng Jiang, Yan-Zhou Wang
Summary: This study explored the role of tonsillar resection in achieving syrinx improvement in adult CM-I patients undergoing PFDD, showing that PFDD with tonsillar resection could be a safe and effective surgical option.
Article
Clinical Neurology
Fatma Ozlen, Baris Kucukyuruk, Orkhan Alizada, Huseyin Guler, Mehmet Yigit Akgun, Ali Metin Kafadar, Saffet Tuzgen, Galip Zihni Sanus, Murat Hanci
Summary: The optimal surgical technique for cerebrospinal fluid flow restoration in CM-1 patients remains controversial. This study demonstrates that CM-1 patients benefit significantly from surgical treatment, with positive outcomes in both surgical groups. Duraplasty should be included in the surgical technique and avoiding arachnoid dissection may lead to better complication rates.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2021)
Article
Orthopedics
Cade A. Morris, D. Alex Forrester, Rosemarie Zanabrie, William Puffinbarger, Neil Borden
Summary: Chiari type 1 malformation is a structural defect of the central nervous system. Syringomyelia can be associated with this condition. Acquired CM-1 with syringomyelia is rare and usually occurs due to factors like increased intracranial pressure and craniocephalic disproportion. We report a rare case of spontaneous idiopathic tonsillar hypertrophy causing unilateral CM-1 with syringomyelia associated with progressive scoliosis in a juvenile. Surgical decompression led to improvement in symptoms.
JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS
(2023)
Article
Clinical Neurology
Shengxi Wang, Dongao Zhang, Kun Wu, Wayne Fan, Tao Fan
Summary: The morphological parameters and CSF dynamics at the craniocervical junction in Chiari malformation type I were measured, and their potential association was analyzed. The bony-PFV, PCF crowdedness, and CSF patency were found to be important indicators of CMI evaluation.
FRONTIERS IN NEUROLOGY
(2023)