Morphometric analysis of the craniocervical juncture in children with Chiari I malformation and concomitant syringobulbia.
BACKGROUND
Although very uncommon, Chiari I malformation (CIM) with syringomyelia may be associated with concomitant syringobulbia. We hypothesized that the anatomy of the craniocervical region may be different in CIM patients with syringomyelia who develop syringobulbia in conjunction with their syringomyelia compared to other patients with CIM with and without syringomyelia. The present study was conducted in order to prove or disprove such a theory.


METHODS
A group of 189 children with operated CIM were reviewed for the presence of syringobulbia, and this cohort then underwent morphometric analyses of their craniocervical juncture. These measurements were then compared to both our prior patient findings and historic controls.


RESULTS
The current study did not identify any morphometrical peculiarities for patients with CIM and syringobulbia compared to other CIM patients with and without isolated syringomyelia.


CONCLUSIONS
Based on our study, the mechanism behind such cerebrospinal fluid distention into the brain stem remains elusive with no single morphometrical difference in patients with CIM and syringobulbia compared to other patients with CIM. Perhaps, future testing aimed at identifying pressure gradients across the foramen magnum in patients with and without syringobulbia and concomitant CIM may be useful.
Tubbs
R Shane
RS
Pediatric Neurosurgery, Children's Hospital, Birmingham, AL 35233, USA. rstubbs@uab.edu
Bailey
Matthew
M
Barrow
William C
WC
Loukas
Marios
M
Shoja
Mohammadali M
MM
Oakes
W Jerry
WJ
D000293:Adolescent; D000704:Analysis of Variance; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000473:pathology*; D001933:Brain Stem / Q000473:pathology*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology*; D013118:Spinal Cord Diseases / Q000150:complications* / Q000473:pathology*; D013595:Syringomyelia / Q000150:complications / Q000473:pathology