title: The odontoid process invagination in normal subjects, Chiari malformation and Basilar invagination patients: Pathophysiologic correlations with angular craniometry.
abstract: BACKGROUND
  Craniometric studies have shown that both Chiari malformation (CM) and basilar invagination (BI) belong to a spectrum of malformations. A more precise method to differentiate between these types of CVJM is desirable. The Chamberlain's line violation (CLV) is the most common method to identify BI. The authors sought to clarify the real importance of CLV in the spectrum of craniovertebral junction malformations (CVJM) and to identify possible pathophysiological relationships.
  
  
  METHODS
  We evaluated the CLV in a sample of CVJM, BI, CM patients and a control group of normal subjects and correlated their data with craniocervical angular craniometry.
  
  
  RESULTS
  A total of 97 subjects were studied: 32 normal subjects, 41 CM patients, 9 basilar invagination type 1 (BI1) patients, and 15 basilar invagination type 2 (BI2) patients. The mean CLV violation in the groups were: The control group, 0.16 ± 0.45 cm; the CM group, 0.32 ± 0.48 cm; the BI1 group, 1.35 ± 0.5 cm; and the BI2 group, 1.98 ± 0.18 cm. There was strong correlation between CLV and Boogard's angle (R = 0.82, P = 0.000) and the clivus canal angle (R = 0.7, P = 0.000).
  
  
  CONCLUSIONS
  CM's CLV is discrete and similar to the normal subjects. BI1 and BI2 presented with at least of 0.95 cm CLV and these violations were strongly correlated with a primary cranial angulation (clivus horizontalization) and an acute clivus canal angle (a secondary craniocervical angle).
authors.affiliation: Department of neurosurgery, Hospital do servidor público do estado de São Paulo, 1800 Pedro de Toledo, 04039-901, São Paulo, Capital, Brazil, 551145738379.
authors.forename: Jânio A
authors.initials: JA
authors.lastname: Ferreira
authors.affiliation: Department of neurosurgery, Hospital do servidor público do estado de São Paulo, 1800 Pedro de Toledo, 04039-901, São Paulo, Capital, Brazil, 551145738379.
authors.forename: Ricardo V
authors.initials: RV
authors.lastname: Botelho
keywords: Arnold–Chiari malformation; basilar impression; cephalometry; platybasia