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Posterior Fossa Measurements in Patients With and Without Chiari I Malformation

Published online by Cambridge University Press:  02 December 2014

John A. Dufton
Affiliation:
Department of Diagnostic Radiology, Kingston General Hospital, Queen's University
Syed Yaser Habeeb
Affiliation:
Queen's University School of Medicine, Kingston
Manraj K. S. Heran
Affiliation:
Department of Radiology, Vancouver General Hospital, Children & Women's Health Centre BC, University of British Columbia, Vancouver, British Columbia, Canada
David J. Mikulis
Affiliation:
Toronto Western Hospital, McLaughlin Pavilion, Toronto, Ontario
Omar Islam
Affiliation:
Department of Diagnostic Radiology, Kingston General Hospital, Queen's University
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Abstract

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Purpose:

To determine if there is a correlation between cerebellar tonsillar descent in patients with and without Chiari I malformation and three skull morphometric measurements: clivus length, anteroposterior diameter of the foramen magnum, and Boogard's angle.

Methods:

Cerebellar tonsillar descent, clivus length, anteroposterior diameter of the foramen magnum, and Boogard's angle were measured in mid-sagittal T1-weighted magnetic resonance images of 188 patients. The study included 81 patients with Chiari I malformations (CMI). Without identifiable pathology, 107 patients served as a comparison group. Two-sample t-tests were used to assess for significance. A Pearson correlation matrix was constructed to assess the strength of linear dependence between measured parameters for the study population.

Results:

A negative correlation was found between tonsillar herniation and clivus length (r = -0.30, P < 0.001), while a positive correlation was found between tonsillar herniation and foramen magnum size (r = 0.15, P = 0.0431), and Boogard's angle (r = 0.23, P = 0.0014). Clivus length was shorter (P = 0.0009) in CMI patients (4.02 cm ± 0.45) than comparison patients (4.23 cm ± 0.42). In addition, the anteroposterior diameter of the foramen magnum was wider (P = 0.0412) (3.74 cm ± 0.40 compared to 3.63 ± 0.30) and Boogard's angle was larger (P = 0.0079) (123.58 degrees ± 8.27 compared to 120.62 degrees ± 6.79) with CMI.

Conclusion:

A greater degree of cerebellar tonsillar herniation is associated with a shorter clivus length, a wider anteroposterior diameter of foramen magnum, and a wider Boogard's angle.

Type
Original Article
Copyright
Copyright © The Canadian Journal of Neurological 2011

References

1 Barkovich, AJ, Wippold, FJ, Sherman, JL, Citrin, CM. Significance of cerebellar tonsillar position on MR. Am J Neuroradiol. 1986;7 (5):7959.Google Scholar
2 Milhorat, TH, Chou, MW, Trinidad, EM, Kula, RW, Mandell, M, Wolpert, C. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1997;44(5):100517.CrossRefGoogle Scholar
3 Meadows, J, Kraut, M, Guarnieri, M, Haroun, RI, Carson, BS. Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging. J Neurosurg. 2000;92(6):9206.CrossRefGoogle ScholarPubMed
4 Sekula, RF, Jannetta, PJ, Casey, KF, Marchan, EM, Sekula, LK, McGrady, CS. Dimensions of the posterior fossa in patients symptomatic for Chiari I malformation but without cerebellar tonsillar descent. Cerebrospinal Fluid Res. 2005;2:117.Google Scholar
5 Schady, W, Metcalfe, RA, Butler, P. The incidence of craniocervical bony anomalies in the adult Chiari malformation. J Neurol Sci. 1987;82:193203.CrossRefGoogle ScholarPubMed
6 Vega, A, Quintana, F, Berciano, J. Basichondrocranium anomalies in adult Chiari type I malformation: a morphometric study. J Neurol Sci. 1990;99(2-3):13745.Google Scholar
7 Nishikawa, M, Sakamoto, H, Hakuba, A, Nakanishi, N, Inoue, Y. Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa. J Neurosurg. 1997;86(1):407.Google Scholar
8 Karagöz, F, Izgi, N, Sencer, SK. Morphometric measurements of the cranium in patients with Chiari type I malformation and comparison with the normal population. Acta Neurochir. 2002; 144(2):16571.Google Scholar
9 Aydin, S, Hanimoglu, H, Tanriverdi, T, Yentur, E, Kaynar, MY. Chiari type I malformations in adults: a morphometric analysis of the posterior cranial fossa. Surg Neurol. 1973;64(3):23741.Google Scholar
10 Noudel, R, Jovenin, N, Eap, C, Scherpereel, B, Pierot, L, Rousseaux, P. Incidence of basioccipital hypoplasia in Chiari malformation type I: comparative morphometric study of the posterior cranial fossa. J Neurosurg. 2009;111(5):104652.Google Scholar
11 Stovner, LJ, Bergan, U, Nilsen, G, Sjaastad, O. Posterior cranial fossa dimensions in the Chiari I malformation: relation to pathogenesis and clinical presentation. Neuroradiology. 1993; 35(2):11318.Google Scholar