Radiometric and Morphologic Analysis of Arnold Chiari Type-I Malformation and Idiopathic Syringomyelia: A Case Series from Pakistan.

Background And Objective: Chiari I Malformation-associated syringomyelia (CM) and idiopathic syringomyelia (IS) are often confused together. They require different diagnostic approach and treatment modalities; it is important to distinguish between the two. We aimed to evaluate the radiological and morphologic characteristics of CM and IS in adult and pediatric patients in Pakistani population.

Postmarketing Safety Surveillance of Topiramate: A Signal Detection and Analysis Study Based on the FDA Adverse Event Reporting System Database.

Objective: This study aims to investigate the occurrence of adverse events associated with topiramate by analyzing data from the FDA Adverse Event Reporting System. The goal is to provide a basis for the safe clinical use of topiramate.

Methods: Adverse event data from the FDA Adverse Event Reporting System, from its inception through the first quarter of 2024, were extracted.

Binaural Processing Deficits in a Child with Chiari Malformation (Type 1).

Chiari malformation is a condition involving caudal descent of the hindbrain which herniates the cerebellar tonsils through the foramen magnum. The purpose of this study was to quantify auditory deficits in an affected individual and to explore the hypothesis that cerebellar malformation specifically disrupts binaural processing. We present audiometric, electrophysiologic, imaging and auditory perceptual findings for a 17-year-old female with Chiari 1 malformation and for a cohort of 35 hearing- and age-matched controls.

A patient with a PTPN11 gene variant complicated with Chiari I malformation and syringomyelia and a review of literatures.

Background: According to previous literature reports, PTPN11 gene variants account for approximately 50% of Noonan syndrome (NS) cases and 85% of Leopard syndrome (LS) cases. Several patients who were diagnosed with NS or LS complicated with Chiari I malformation (CIM) and/or syringomyelia have been reported to have a PTPN11 variant. However, it is not always clear whether the association between CIM and/or syringomyelia and PTPN11 variants is real or random.

Craniosynostosis-4 with Heterozygous Mutation in the Gene: A Case Report.

Background: Craniosynostosis (CS) is defined as the premature fusion of cranial sutures and can be classified as nonsyndromic or syndromic and by which sutures are affected. It affects 1 in 2,000-2,500 children. The most common clinical feature in CS is an abnormal head shape.

T-shaped myofascial incision for Chiari I malformation surgery without dural closure in children: Technical note.

Background: Like in all posterior fossa surgeries the avoidance of cerebrospinal fluid (CSF) leaks is of paramount importance for foramen magnum decompression in Chiari I malformation in children. The present technical note decribes the experience with the creation of a T-shaped myofascial cuff to reduce the risk of postoperative CSF leaks.

Methods: The medical records of 98 children were evaluated.

Correlation of anterior CSF space in the cervical spine with Chicago Chiari Outcome Scale score in adult females.

Objective: Craniocervical junction morphology has been associated with Chiari malformation type I (CMI) symptom severity; however, little is known about its deterministic effect on surgical outcomes in patients across age and sex differences. The goal of the present study was to assess the effects of age and sex on surgical outcomes in CMI.

Methods: In the present study, the authors examined MRI-based morphometric data from 115 individuals diagnosed with CMI (54 adults including 39 women and 15 men, and 61 children including 24 girls and 37 boys) and correlated them with Chicago Chiari Outcome Scale (CCOS) scores obtained 1 year after posterior fossa decompression.

Impacts of type 1 Chiari malformation on elderly.

Background: This study aims to evaluate the surgical outcomes of elderly patients with Chiari malformation (CM) who underwent suboccipital craniectomy (SC) with duraplasty (DP) or dural splitting (DS). The focus is on symptom relief, changes in syrinx size, hospital admission duration, and postoperative complications.

Methods: A retrospective study was performed to evaluate the outcomes of elderly CM patients who underwent SC with DP or dural splitting (DS).

Artificial intelligence versus clinical judgement: how accurately do generative models reflect CNS guidelines for chiari malformation?

Objective: This study investigated the response and readability of generative artificial intelligence (AI) models to questions and recommendations proposed by the 2023 Congress of Neurological Surgeons (CNS) guidelines for Chiari 1 malformation.

Methods: Thirteen questions were generated from CNS guidelines and asked to Perplexity, ChatGPT 4o, Microsoft Copilot, and Google Gemini. AI answers were divided into two categories, "concordant" and "non-concordant," according to their alignment with current CNS guidelines.

Arnold-Chiari Malformations in Pediatric Patients After Fetal Surgery for Meningomyelocele.

(1) : Fetal surgery for meningomyelocele (MMC) should reduce the occurrence of Arnold-Chiari malformations, hydrocephalus, the associated need for craniocervical decompression, and the need for cerebrospinal fluid shunt insertion. Fetal surgery should improve ambulatory status. (2) : We used retrospective analysis of the documentation and descriptive statistics to summarize the clinical data and measured MRI parameters.

Free-floating bone flap posterior cranial vault release in syndromic craniosynostosis.

The aim of this study was to investigate the efficacy of non-detachable free-floating bone flap posterior cranial vault release (FFBF-PCVR) in syndromic craniosynostosis. A retrospective review was completed of subjects who underwent FFBF-PCVR at 4 time-points: within 3 months preoperatively, 7 days postoperatively, 3 months postoperatively and at the last follow-up postoperatively. Volumetric and craniometric data, the ratio of ventricular diameter, and the cerebellar tonsillar descent were measured after FFBF-PCVR by using computed tomographic and magnetic resonance imaging.

CT-based and manual external skull measurements for Chiari-like malformation and syringomyelia in Pomeranians.

Studies in Pomeranians as well as other breeds have looked at clinical signs or external features as predictors of Chiari-like malformation (CM) and syringomyelia (SM). The aim of this study is to describe and analyze morphometric factors of the skull of Pomeranians with and without CM/SM by means of CT as well as manual external measurements. Ninety-two Pomeranians >12 months of age were included that underwent both CT and MRI studies of the head and cervicothoracic vertebral column.

Utilization of Vestibular Information for Balance Control in Children with Chiari I Malformation.

(1) Background: Surgery for Chiari I malformation (CMI) is indicated when typical clinic-radiological features (syringomyelia, exertional headaches, sleep apnea syndrome, and tetraparesis) are present. Sometimes, patients have atypical complaints suggestive of otolaryngological (ENT) involvement, and it is sometimes difficult for the neurosurgeon to determine if these complaints are related to the CMI. Our aim was to describe postural control patterns in children with CMI using computerized dynamic posturography.

Incidence of Subdural Hygroma on Routine Early Postoperative Imaging Following Foramen Magnum Decompression for Chiari Malformation Type 1 in 156 Patients.

Objective: To determine the incidence of subdural hygroma (SDH) on routine early postoperative imaging following foramen magnum decompression (FMD) with dural opening in patients with Chiari 1 malformation (CM1).

Methods: Clinical and radiological data of 156 consecutive patients with CM1 who underwent FMD (2006-2023) were retrospectively analyzed. Computed tomography scans done on the seventh postoperative day or earlier were reviewed for the presence of SDH (infra-and supratentorial) and ventriculomegaly.

Relation of the Pituitary Gland With the Sella Turcica in Adult Patients With Chiari Malformation Type 1.

Objective: This study aims to assess the relation of the pituitary gland height (PGH) with the heights of the tuberculum sellae (TSH) and dorsum sellae (DSH) in adult patients with Chiari malformation type 1 (CM1).

Methods: Magnetic resonance imaging (MRI) views of 50 CM1 patients aged 20 to 71 years and 50 controls aged 20 to 65 years were included in the study.

Results: CM1 patients (6.

Remnants of right venous valve in utero and early postnatal life. Case report and literature review.

During fetal life the right valve of the sinus venosus directs oxygenated blood from the inferior vena cava to the left atrium through the foramen ovale, until the regression of the right valve which usually occurs within the 15th week of pregnancy. Incomplete regression of the right venous valve in varying degrees can lead to different types of remnants such as the Eustachian valve, the Chiari Network and Cor Triatriatum Dexter. Prenatal diagnosis of remnants of right venous valve has only rarely been reported in the literature.