Correlation between Magnetic Resonance Cerebrospinal Fluid Flowmetry with the Clinical Outcome of Craniocervical Decompression Surgery for Chiari Type One Patients
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- Category: Vol. 89, March 2021
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Correlation between Magnetic Resonance Cerebrospinal Fluid Flowmetry with the Clinical Outcome of Craniocervical Decompression Surgery for Chiari Type One Patients, MOHAMED A. THABIT, EHAB ABDELHALEM ALI, WESSAM ABDELRAHMAN ELZAYAT and OMAR ABDELALEEM RAGAB
Abstract
Background: Patients having chiari 1 have caudal dis-placement of the cerebellar tonsils more than 5mm below theforamen magnum. The brainstem is in a normal position. Theymay or may not have a syrinx. The 5-mm “rule” concerningthe definition of the pathologic extent of the caudal migration of the tonsils is arbitary. Patients with a Chiari1 Malformation may present with a variety of symptoms and signs ranging from headache to severe myelopathy and brainstem compromise. Chiari malformation type I develops as the skull and brain are growing. As a result, signs and symptoms may not occur until late childhood or adulthood Structural MRI is the main imaging diagnostic tool, often accompanied by cine Phase-Contrast (PC) MRI of the Cerebrospinal Fluid (CSF) flow.Aim of Study: To establish a correlation between clinicaland MRI flowmetry following craniocervical decompressionsurgery.Patients and Methods: Twenty patients with symptomaticchiari 1 malformation had MRI flowmetric studies prior tosurgery and six months post-operatively and the flowmetryresults are assigned to each patient in comparison with clinicalimprovement.Results: Sixteen patients had clinical and radiologicalimprovement,one patient clini-cally stayed the same thoughradiologically improved and 3 patients deterio-rated clinicallywith radiological evidence of CSF flow obstruction neededresurgery.Conclusion: CSF flowmetry is a good diagnostic andprognostic tool in chiari type 1 malformation.