The development of MRI technology has greatly facilitated the diagnosis of Chiari Malformation and syringomyelia. The surgical treatment is not standardized and a variety of procedures are used to treat these patients because the pathophysiology is still controversial. The aim of this study has been to characterize the properties of the CSF hydrodynamic at the level of the foramen magnum before and after posterior fossa decompression in patient with Chiari I Malformation. The clinical information and surgical protocol will be presented. The patients were studied with pre-operative and post-operative magnetic resonance images. The position of the tonsils and obex, the patency of subarachnoid space at the level of the foramen magnum and the syrinx extension were registered in each patient. Velocity encoded phase contrast M. R. (magnetic resonance) were performed to measure the cerebral blood flow and the CSF How through the cranio-cervical region. The CSF peak and average velocity. CSF flow, and CSF flow waveforme were evaluated at the level of the foramen magnum. The CSF flow in the syrinx was also quantified. The pre-operative oscillatory CSF flow in patients with Chiari I malformation was lower that the normal average and a significant increase of the flow was seen after posterior fossa decompression. Pulsatile flow was observed in the syrinx moving synchronously with the cardiac cycle. The CSF flow in the upper cervical subarachnoid space was also synchronized with the syrinx flow. The pathophysiology of Chiari malformation will be reviewed and the role of the CSF quantitative MRI analyses in Chiari Malformations as a predictor factor to select surgical candidates will be discussed.
|Original language||English (US)|
|Number of pages||1|
|Journal||Skull Base Surgery|
|Issue number||SUPPL. 1|
|State||Published - Dec 1 1997|
ASJC Scopus subject areas
- Clinical Neurology