The Association between Sleep‐Disordered Breathing and Magnetic Resonance Imaging Findings in a Pediatric Cohort with Chiari 1 Malformation

Abstract

A direct relationship between the degree of cerebellar tonsillar herniation and obstructive sleep apnea was demonstrated. However, further prospective studies that include neurophysiological assessment are needed to further translate the central nervous system imaging findings to predict the presence of SDB.

Pediatric Chiari malformation type I: long‑term outcomes following small‑bone‑window posterior fossa decompression with autologous‑fascia duraplasty

“…Innate bias, however, is inevitable in an in-hospital cohort. Sleep apnea and feeding problems are reported to be more common in pediatric patients, although other clinical manifestations appear to be similar in different age groups (6). As previously reported, the most common presenting symptom of CM-I is headache (4), which is consistent with the current findings.…”

“…With the advent of magnetic resonance imaging (MRI), however, the number of pediatric patients diagnosed with CM-I is increasing (4). Previous studies have described the clinical features of CM-I in pediatric populations (2,5,6).…”

Utility of brain MRI in children with sleep‐disordered breathing

“…Of those with isolated OSA, nearly one‐half had abnormal brain MRI findings. Although CSA is traditionally regarded as the most frequent respiratory complication of brain abnormalities, more recent literature has shown that neuroanatomical malformations can contribute to OSA in the absence of adenotonsillar hypertrophy . Likewise, our findings reinforce the importance of obtaining a brain MRI to detect potential neuroanatomical causes of OSA.…”

“…In children, isolated OSA in the absence of adenotonsillar hypertrophy, persistent OSA following AT, and OSA with coexisting significant CSA pose a dilemma for clinicians. Although previous studies have shown that underlying neuroanatomical abnormalities can contribute to persistent isolated OSA in the absence of adenotonsillar hypertrophy, CSA, and NH, the present study is the first descriptive study of brain MRI findings following a PSG diagnosis of a sleep disorder to determine outcomes for brain imaging in a heterogeneous population consisting of nonsyndromic and syndromic children.…”

“…Because the extent of tonsil herniation is lesser than that of CM type 1, its role in SDB continues to be evaluated . Due to the location of the CM, structures at the craniovertebral junction are compressed, resulting in damage to respiratory control centers leading to SDB such as OSA, CSA, and NH . Where CSA and NH are common among patients with CM, CM can also contribute to OSA .…”