Posterior cranial fossa and cervical spine morphometric abnormalities in symptomatic Chiari type 0 and Chiari type 1 malformation patients with and without syringomyelia

Богданов, Э. И.; Файзутдинова, А Т; Heiss, John D.

doi:10.1007/s00701-021-04941-w

Cited by 13 publications

(14 citation statements)

References 51 publications

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“…For instance, Hidalgo et al. (38) performed IDD on 28 CIMs with typical headaches, and 57% of cases experienced complete relief before discharge, and typical headaches disappeared completely in all cases within six months, substantiating its strong and effective decompressive effect.…”

Section: Surgery For Typical Headachementioning

confidence: 95%

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Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review

Zhang

Huang

et al. 2023

Cephalalgia

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Objective A meta-analysis was conducted to analyze the incidence of typical and atypical headaches and outcomes following various treatments in patients with Chiari I malformation. Background Headache is the most common symptom of Chiari malformation, which can be divided into typical and atypical subgroups to facilitate management. Much controversy surrounds the etiology, prevalence and optimal therapeutic approach for both types of headaches. Method We identified relevant studies published before 30 July 2022, with an electronic search of numerous literature databases. The results of this study were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Result A total of 1913 Chiari malformation type I CIM patients were identified, 78% of whom presented with headache, within this group cephalgia was typical in 48% and atypical in 29% of patients, and migraine was the most common type of atypical headache. The ratio of typical/atypical headaches with international classification of headache disorders diagnosis was 1.53, and without international classification of headache disorders diagnosis was 1.56, respectively. The pooled improvement rates of typical headaches following conservative treatment, extradural decompression and intradural decompression were 69%, 88%, and 92%, respectively. The corresponding improvement rates for atypical headaches were 70%, 57.47%, and 69%, respectively. The complication rate in extradural decompression group was significantly lower than in intradural decompression group (RR, 0.31; 95% CI: 0.06–1.59, I2 = 50%, P = 0.14). Low reoperation rates were observed for refractory headaches in extradural decompression and intradural decompression groups (1%). Conclusion The International Classification of Headache Disorders can assist in screening atypical headaches. extradural decompression is preferred for typical headaches, while conservative therapy is optimal for atypical headaches. A definite correlation exists between atypical headaches and Chiari Malformation Type I patients with higher prevalence than in the general population. Importantly, decompression is effective in relieving headaches in this particular patient population.

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Section: Surgery For Typical Headachementioning

confidence: 95%

“…In contrast, Pascual et al (20,34) found that all cases of cough headache were associated with CIM, which has led to some scholars equating Valsalva headache to CIM typical headache (14,(35)(36)(37). Interestingly, another group of scholars characterized a typical headache of CIM as a posterior occipital headache (38).…”

Section: The Typical Headache Of Cimmentioning

confidence: 99%

Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review

Zhang

Huang

et al. 2023

Cephalalgia

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“…• Chiari type 0: presence of symptoms of type I CM, with caudal displacement of the cerebellar tonsils of less than 5 mm with or without associated cervical syringomyelia [1,5].…”

Section: Morphological Classification Of Chiari Malformationsmentioning

confidence: 99%

Chiari Malformations: A Review of the Current Literature

Rodríguez¹

2023

Arch Clin Trial & Case Rep.

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Chiari malformations (CM) are a group of malformations involving the posterior fossa and rhombencephalic structures that may have other associated intra- or extracranial defects. Initially, the 4 classic varieties were described by the Austrian pathologist Hans Chiari towards the end of the 19th century; years later, the Swiss pathologist Julius Arnold described a case of type II CM with associated myelomeningocele. years later, two of his students used the term "Arnold-Chiari Malformation", this term is often misused for all types. Currently it is estimated that the incidence and prevalence data are underestimated due to the asymptomatic presentation of the pathology in many cases and the limited access to health services of different populations at a global level, for this reason the epidemiological data vary between the literature. The original classification has been modified by contributions from various authors in order to more precisely describe the variety of morphological findings; currently the classification includes CM types 0, I, 1.5, II, III and IV. The symptoms and associated pathological conditions vary for each type and type III and IV are the most severe forms. Diagnosis requires that secondary causes of cerebellar tonsillar ectopy (main finding of CM) be ruled out, along with a physical examination, neurological evaluation, and complementary tests; however, diagnosis requires resonance neuroimaging to demonstrate the findings. The management basically consists of performing a decompression of the posterior fossa and whose main indication is to reduce the symptoms, however, it should be noted that there is no global agreement among specialists on the subject of surgical management, for which each patient must be individualized by your treating physician and the decision made is subject to individual criteria.

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“…In 2021, Bogdanov et al 32 divided 120 small PCF patients into four groups: CM0 without syrinx; CM0 with syrinx; CMI without syrinx; and CMI with syrinx. However, a small PCF was controversially identified if the clivus and supraocciput lengths were less than 40mm, without using volumetric measurements.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Previous studies have shown that some two-dimensional parameters including the clivus angle, [45][46][47] M-line-FVV distance, 16,32,48,49 and cranial base angle 45,[50][51][52] can partly reflect the severity of PCF deformity in CMIs. Here, we showed that the CVJCSI was independently correlated with the clivus angle, M-line-FVV distance, and cranial base angle, suggesting that the CVJCSI can be a reliable indicator for CVJ compression and posterior fossa deformity.…”

Section: Superiority Of the Cvjcsi Over Other Solo Morphometric Varia...mentioning

confidence: 99%

A Novel Craniocervical Junction Compression Severity Index-Based Grading System for Multidirectional Quantification of the Biomechanics at Foramen Magnum of Chiari Malformation Type I

Liu

Zhang

et al. 2022

J Neurol Surg B Skull Base

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Objective This study aimed to establish a novel grading system, based on the craniovertebral junction compression severity index (CVJCSI) for multidirectional quantification at the foramen magnum plane for Chiari malformation type I (CMI). Methods The CVJCSI grading system was established to stratify patients based on the ventral (modified clivoaxial angle < 138°), dorsal (tonsil herniation), and central (brainstem herniation) CVJ compression, the CVJCSI grading system was established to stratify patients. The optimal surgical method for each grade was recommended by intragroup comparisons regarding the efficacy of the three operations. Finally, according to the CVJCSI grading system, a prospective validation trial was performed and surgically treated for internal validation. Results Based on the retrospective study (n = 310), the CVJCSI included six grades: I- syrinx alone without compression; II- dorsal compression; III- dorsal, and central compression; IV- ventral compression; V- dorsal, and ventral compression; and VI– ventral, dorsal, and central compression. Among all available variables, only the CVJCSI and surgical methods significantly affected the CCOS. The CCOS scores, overall and for each CVJCSI grade, in the prospective cohort (n = 42) than in the retrospective analysis. Conclusions The CVJCSI can be used to stratify CMI patients. The higher the CVJCSI grade, the more severer the CVJ compression and the worse posterior fossa deformity. Meanwhile, the CVJCSI was negatively correlated with the CCOS. The lower the CVJCSI grade, the better the response to surgery, and the less-invasive surgical procedure were warranted. Finally, the prospective cohort study validated the proposed CVJCSI-based surgical protocols.

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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

Cited by 13 publications

References 51 publications

Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review

Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review

Chiari Malformations: A Review of the Current Literature

A Novel Craniocervical Junction Compression Severity Index-Based Grading System for Multidirectional Quantification of the Biomechanics at Foramen Magnum of Chiari Malformation Type I

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