Kinematic analysis of the hindbrain via dynamic neck motion in adult patients with Chiari malformation type I: A radiological study with clinical implications.

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY
Hao Deng, Tao Chen, Guolian Chen, Wei Tang, Zhijian Huang, Yi Yan, Yongzhi Xia
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引用次数: 0

Abstract

Background: The influence of cervical motion on the hindbrain in patients with Chiari malformation type I (CMI) remains under investigation. In this study, the kinematic effects of cervical extension and flexion on cerebellar tonsillar herniation were evaluated.

Methods: The clinical data of 27 adult CMI patients were retrospectively studied, and sex- and age-matched patients with cervical spondylopathy were included as controls. Several linear, angular variables related to the hindbrain and mobility of the neck were assessed on midsagittal views of neutral and dynamic cervical MR images.

Results: The distance of cerebellar tonsillar herniation (D-Ton) in the CMI group was 10.15 ± 0.74 mm in the cervical neutral position, 11.24 ± 0.81 mm (p <0.001) in flexion, and 9.12 ± 0.65 mm (p <0.001) in extension. D-Ton in the control group remained unchanged in three different cervical positions. No significant differences were found in the tissue strain of the tonsils (Ton-Strain), the distance from the obex (D-Obex), the anterior margin of the pontomedullary (D-Pon), or the cervicomedullary (D-Medu) junction to the McRae line between different cervical positions in either group.

Conclusions: The mobility of the ectopic tonsils and the degree of cervical motion were verified in adult CMI patients. The herniated tonsils largely ascended with extension and descended with flexion, without obvious tonsillar tissue strain, whereas the brain stem remained stable. Tonsillar motion may be a potential marker of CMI and may therefore help surgeons confirm CMI as well as tailor surgical procedures for such patients.

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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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