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
Medicine, General & Internal
Raquel Rodriguez-Blanque, Cristina Almazan-Soto, Beatriz Piqueras-Sola, Juan Carlos Sanchez-Garcia, Andres Reinoso-Cobo, Maria Jose Menor-Rodriguez, Jonathan Cortes-Martin
Summary: Arnold Chiari syndrome is a rare congenital disease with unknown prevalence and origins that are still being studied. The symptoms range widely and early diagnosis is difficult. Treatment involves surgical decompression, but there is a high risk of residual symptoms. Recent research suggests a possible genetic basis for the syndrome.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Giuseppe Talamonti, Marco Picano, Maria Fragale, Eleonora Marcati, Giulia Meccariello, Davide Boeris, Marco Cenzato
Summary: The issue of unsuccessful surgery for Chiari-1 malformation (CM-1), as well as its potential causes and possible solutions, has been poorly documented. A retrospective review of patients with CM-1 showed a high rate of complications and failures, suggesting the need for proper indications and careful technique to avoid re-operations.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Genetics & Heredity
Aldesia Provenzano, Andrea La Barbera, Mirko Scagnet, Angelica Pagliazzi, Giovanna Traficante, Marilena Pantaleo, Lucia Tiberi, Debora Vergani, Nehir Edibe Kurtas, Silvia Guarducci, Sara Bargiacchi, Giulia Forzano, Rosangela Artuso, Viviana Palazzo, Ada Kura, Flavio Giordano, Daniele di Feo, Marzia Mortilla, Claudio De Filippi, Gianluca Mattei, Livia Garavelli, Betti Giusti, Lorenzo Genitori, Orsetta Zuffardi, Sabrina Giglio
Summary: The study found that the frequency of Type 1 Chiari malformation is widely underestimated, with some variants inherited from parents with C1M. This condition is mostly inherited in a dominant manner, and alterations in genes that regulate chromatin architecture may cause localized anatomical changes and symptoms of varying degrees.
Article
Medicine, General & Internal
Luca Massimi, Davide Palombi, Ilaria Contaldo, Chara Veredice, Daniela Rosaria Pia Chieffo, Rosalinda Calandrelli, Gianpiero Tamburrini, Domenica Immacolata Battaglia
Summary: This study aimed to investigate the correlation between Chiari 1 malformation (CM1) and epilepsy. The results showed no significant clinical correlation between CM1 and epilepsy, and the course of both conditions depended on surgery and antiepileptic drugs.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Clinical Neurology
Moeid Heidary, Michael Respondek, Joerg Klekamp
Summary: Histological changes of the arachnoid correlate with preoperative symptoms, while relationships between the arachnoid and surrounding tissues show higher correlations with predictive power for short- and long-term outcomes. These findings suggest a pathophysiological role for the arachnoid in Chiari I malformation.
ACTA NEUROCHIRURGICA
(2021)
Article
Clinical Neurology
Palma Ciaramitaro, Luca Massimi, Alessandro Bertuccio, Alessandra Solari, Mariangela Farinotti, Paola Peretta, Veronica Saletti, Luisa Chiapparini, Andrea Barbanera, Diego Garbossa, Laura Valentini
Summary: This study aimed to reach a consensus among international experts on controversial issues in the diagnosis and treatment of Chiari 1 malformation and syringomyelia in adults. Through a multidisciplinary panel, a Delphi process, and face-to-face discussions, a consensus was reached on 57 out of 63 statements related to the conditions. The consensus document, consisting of 63 statements, was the result of expert discussion and serves as a guide for clinicians and researchers following adults with Chiari and syringomyelia.
NEUROLOGICAL SCIENCES
(2022)
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
Clinical Neurology
Davis G. Taylor, Ajay Chatrath, Panagiotis Mastorakos, Gabriella Paisan, Ching-Jen Chen, Thomas J. Buell, John A. Jane
Summary: Syringogenesis in CM-I patients is associated with decreased subarachnoid CSF spaces at the cranial outlet. Successful resolution of syrinx post-surgery correlates with increased subarachnoid space expansion.
JOURNAL OF NEUROSURGERY
(2021)
Article
Medicine, General & Internal
Cyrille Capel, Romaric Lantonkpode, Serge Metanbou, Johann Peltier, Olivier Baledent
Summary: This study investigates the relationship between venous drainage distribution and cerebrospinal fluid dynamics in CM1 patients, and finds a close correlation between venous drainage and compensatory cerebrospinal fluid involvement, potentially contributing to the formation of syrinxes.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Dario Cocito, Erdita Peci, Diego Garbossa, Palma Ciaramitaro
Summary: This study evaluated the transcranial magnetic stimulation of the phrenic nerve in patients with Chiari syndrome and/or syringomyelia, and found neurophysiological alterations in the diaphragmatic pathway, especially in patients with bulbar/cervical syringomyelia.
JOURNAL OF CLINICAL MEDICINE
(2022)
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
Medicine, General & Internal
Palma Ciaramitaro, Giuseppe Migliaretti, Marilena Ferraris, Andrea Garnero, Giovanni Morana, Paolo Carucci, Ilaria Stura, Fulvio Massaro, Diego Garbossa
Summary: This study investigated presurgery hydrodynamic markers in patients with syringomyelia and Chiari 1 malformation to evaluate their association with clinical and radiological improvement after surgery. The results showed that presurgical cerebrospinal fluid flow at the craniocervical junction predicted post-surgical pain relief and prognoses. Changes in the fourth ventricle area before surgery could provide useful information for evaluating long-term surgical outcomes.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Clinical Neurology
Venetia Giannakaki, Jack Wildman, K. Thejasvin, Georgios Pexas, Justin Nissen, Nicholas Ross, Patrick Mitchell
Summary: The study compared three different surgical techniques for foramen magnum decompression in treating Chiari malformation. It was found that the highest revision rate was observed in patients who underwent bony decompression without dural opening, while the highest occurrence of postoperative headache and nausea was found in the durotomy group. Overall, duraplasty showed the best results.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Luca Massimi, Paola Peretta, Alessandra Erbetta, Alessandra Solari, Mariangela Farinotti, Palma Ciaramitaro, Veronica Saletti, Massimo Caldarelli, Alexandre Casagrande Canheu, Carlo Celada, Luisa Chiapparini, Daniela Chieffo, Giuseppe Cinalli, Federico Di Rocco, Marika Furlanetto, Flavio Giordano, George Jallo, Syril James, Paola Lanteri, Christian Lemarchand, Martina Messing-Juenger, Cecilia Parazzini, Giovanna Paternoster, Gianluca Piatelli, Maria A. Poca, Prab Prabahkar, Federica Ricci, Andrea Righini, Francesco Sala, Juan Sahuquillo, Marcus Stoodley, Giuseppe Talamonti, Dominic Thompson, Fabio Triulzi, Mino Zucchelli, Laura Valentini
Summary: Through the Delphi study, an international panel of experts reached consensus on the diagnosis and treatment of CM1 in children, with a total of 58 statements covering four main sections including Definition and Classification, Planning, Surgery, and Isolated Syringomyelia. The article emphasizes the need for establishing an international network and registry, as well as promoting collaborative studies to enhance the evidence base and optimize long-term care for this patient population.
NEUROLOGICAL SCIENCES
(2022)