Posterior cranial fossa crowdedness is related to age and sex: an magnetic resonance volumetric study

Lirng, Jiing Feng; Fuh, Jong Ling; Chen, Y.-Y.; Wang, S.-J.

doi:10.1080/02841850500216269

Cited by 14 publications

(8 citation statements)

References 10 publications

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“…During the past decades, the PCF morphometry has been widely explored in TN. Previous studies indicated that the PCF morphometry might be similar in healthy subjects and classic TN patients (18,28,29). In addition, a smaller PCF was merely characterized as TNs without NVC, so-called idiopathic TNs (18).…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Trigeminal Neuralgia Caused by Sole Arterial and Venous Compression: Clinical Features and Surgical Outcomes From 222 Cases

et al. 2021

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Background: Compared with trigeminal neuralgia (TN) caused by arterial neurovascular conflict (NVC), the clinical characteristics and managements for TN with venous NVC are not well-established. This study aims to comparatively summarize the clinical features and surgical outcomes of microvascular decompression (MVD) for patients with TN caused by sole arterial and venous compression, with a particular focus on the morphological features of posterior cranial fossa (PCF).Methods: A total of 222 patients with TN caused by sole arterial NVC (188/84.7%) and venous NVC (34/15.3%) underwent MVD in our department from January 2014 to December 2018. The patient data were analyzed retrospectively. Particularly, we focused on the potential impact of PCF on surgical outcomes.Results: Compared with arterial NVC, V3 branch of the trigeminal nerve was more frequently involved in venous NVC (p = 0.009). The most common compression site was root entry zone for arterial NVC (68.6%) and midcisternal segment for venous NVC (76.5%) (p < 0.001). No serious post-operative complication was observed in the two groups. Both short- and long-term outcomes were relatively worse in venous NVC cases compared with arterial NVC cases (p = 0.001 and p = 0.030, respectively); and a dominantly higher rate of delayed cure was demonstrated in venous NVC cases (p < 0.001). TN patients with venous NVC revealed a more flat-shaped PCF than those with arterial NVC. Moreover, flat-shaped PCF morphometry was negatively correlated with surgical outcomes of TN patients with arterial NVC, but not with those of venous NVC cases.Conclusions: MVD is an effective and safe treatment for patients with TN caused by either arterial or venous NVC. Patients with a more flat-shaped PCF might be vulnerable to venous compression. Our study demonstrated that PCF morphometry only affected the surgical outcomes of patients with TN caused by arterial NVC, but not the outcomes of those with venous NVC.

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Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Trigeminal Neuralgia Caused by Sole Arterial and Venous Compression: Clinical Features and Surgical Outcomes From 222 Cases

et al. 2021

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“…Finally, the results presented here are not matched by age and morphology which has been shown to be altered with age. 19,23,27,28,43,50 However, this age effect predominately impacts older populations such that the effect is likely small for a study population younger than 50 years of age. Less than 10% of our CMI and control subjects were older than 50 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…28 Also, Hayakawa et al found no significant differences in the midsagittal area of the pons or the cerebellar vermis between the 21-40 year old group and 51-60 year old group. 17 In addition, PCF crowdedness was reported as negatively correlated with age (0.8% per decade) by Lirng et al 27 However, the effect of age on PCF crowdedness between the ages of 24 and 50 years is not easily discernible due to the large variance within a small study population. Thus, one should control for demographics in brain morphological group comparisons.…”

Section: Introductionmentioning

confidence: 97%

“…It is well established in the literature that cerebellar volume reduces with age (from 2 to 5% per decade on average). 19,23,27,28,43,50 This volume reduction is nonlinear with age and dramatically accelerates after middle age. Luft et al demonstrated a 26.6% decrease in cerebellar volume from age 50 to 73 with only a 0.71% decrease from 19.8 to 50 years of age.…”

Section: Introductionmentioning

confidence: 99%

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Quantification of Cerebellar Crowding in Type I Chiari Malformation

et al. 2018

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This study was focused on a semi-automated morphometric analysis of the cerebellum in the mid-sagittal plane as an alternative to tonsillar descent alone in the evaluation of Chiari malformation type 1 (CMI) patients. Morphometric analyses of posterior fossa structures were performed on mid-sagittal MRI images of 375 individuals (females, > 18 years, 235 CMI and 140 healthy controls). Twenty-six parameters including linear, angular and area measurements together with non-dimensional ratios were calculated. Eighteen parameters were found to be significantly different between CMI and control subjects. Smaller posterior cranial fossa (PCF) area in CMI subjects was attributed to a smaller PCF area anterior to the brainstem. The cerebellar area was found to be larger in CMI subjects as compared to controls (15.1%), even without inclusion of the tonsillar area below the foramen magnum (FM) (8.4%). The larger cerebellar area in CMI subjects was due to cranialcaudal elongation of the cerebellum, predominately below the fastigium. The cerebrospinal fluid spaces below the FM were smaller in CMI subjects as compared to controls. Overall, greater cerebellar crowding was identified in CMI subjects relative to healthy controls. These observations may improve our understanding of the pathophysiology of CMI in adult female patients.

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“…Lirng et al 9 used manual delineation of the PCF in MR imaging followed by image intensity-based segmentation of brain tissue and CSF to assess the effect of age and sex on the PCF volume and crowdedness in healthy subjects. They found that overall, men had a larger PCF and hindbrain volume, whereas women demonstrated a higher degree of crowdedness, which may explain the higher frequency of CMI in women.…”

mentioning

confidence: 99%

Automated Posterior Cranial Fossa Volumetry by MRI: Applications to Chiari Malformation Type I

Bagci¹,

Lee²,

Nagornaya³

et al. 2013

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE Quantification of PCF volume and the degree of PCF crowdedness were found beneficial for differential diagnosis of tonsillar herniation and prediction of surgical outcome in CMI. However, lack of automated methods limits the clinical use of PCF volumetry. An atlas-based method for automated PCF segmentation tailored for CMI is presented. The method performance is assessed in terms of accuracy and spatial overlap with manual segmentation. The degree of association between PCF volumes and the lengths of previously proposed linear landmarks is reported. MATERIALS AND METHODS T1-weighted volumetric MR imaging data with 1-mm isotropic resolution obtained with the use of a 3T scanner from 14 patients with CMI and 3 healthy subjects were used for the study. Manually delineated PCF from 9 patients was used to establish a CMI-specific reference for an atlas-based automated PCF parcellation approach. Agreement between manual and automated segmentation of 5 different CMI datasets was verified by means of the t test. Measurement reproducibility was established through the use of 2 repeated scans from 3 healthy subjects. Degree of linear association between PCF volume and 6 linear landmarks was determined by means of Pearson correlation. RESULTS PCF volumes measured by use of the automated method and with manual delineation were similar, 196.2 ± 8.7 mL versus 196.9 ± 11.0 mL, respectively. The mean relative difference of −0.3 ± 1.9% was not statistically significant. Low measurement variability, with a mean absolute percentage value of 0.6 ± 0.2%, was achieved. None of the PCF linear landmarks were significantly associated with PCF volume. CONCLUSIONS PCF and tissue content volumes can be reliably measured in patients with CMI by use of an atlas-based automated segmentation method.

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Posterior cranial fossa crowdedness is related to age and sex: an magnetic resonance volumetric study

Abstract: Our study shows that PCF CI is associated with age and sex, and can therefore be used as a surrogate to assess hindbrain atrophy in a cross-sectional sample. Moreover, sex- and age-specific normal ranges may be needed to evaluate the PCF CI in clinical practice.

Cited by 14 publications

References 10 publications

Comparative Analysis of Trigeminal Neuralgia Caused by Sole Arterial and Venous Compression: Clinical Features and Surgical Outcomes From 222 Cases

Comparative Analysis of Trigeminal Neuralgia Caused by Sole Arterial and Venous Compression: Clinical Features and Surgical Outcomes From 222 Cases

Quantification of Cerebellar Crowding in Type I Chiari Malformation

Automated Posterior Cranial Fossa Volumetry by MRI: Applications to Chiari Malformation Type I

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