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01-11-2020 | Chiari Malformation | Diagnostic Neuroradiology

Clivus length distinguishes between asymptomatic healthy controls and symptomatic adult women with Chiari malformation type I

Authors: Blaise Simplice Talla Nwotchouang, Maggie S. Eppelheimer, Alaaddin Ibrahimy, James R. Houston, Dipankar Biswas, Richard Labuda, Jayapalli Rajiv Bapuraj, Philip A. Allen, David Frim, Francis Loth

Published in: Neuroradiology | Issue 11/2020

Abstract

Purpose

While the presence of cerebellar tonsillar descent in radiological images has been used as evidence of Chiari malformation type I (CMI), tonsillar ectopia alone is insufficient to identify individuals with symptomatic CMI. This study sought to identify differences in brain morphology between symptomatic CMI and healthy controls in adult females.

Methods

Two hundred and ten adult females with symptomatic CMI and 90 age- and body mass index-matched asymptomatic female controls were compared using seven brain morphometric measures visible on magnetic resonance images. The CMI and control groups were divided into four subgroups based on the tonsillar position (TP) relative to the foramen magnum: group 1 was made up of healthy controls with normal TP (TP < 0 mm); group 2 was comprised of control individuals with low-lying TP (1–5 mm); group 3 was comprised of symptomatic CMI patients with low-lying TP (1–5 mm); group 4 contained symptomatic CMI patients with severe tonsillar descent (6–13 mm).

Results

All morphometrics for symptomatic CMI with severe tonsillar descent were significantly different than those for both control groups. The CMI group with low-lying TP was significantly different for four measures when compared to controls with normal TP. However, only clivus length was statistically different between the CMI and healthy control groups with low-lying TP.

Conclusion

This study demonstrates that clivus length distinguishes adult female healthy individuals with low-lying tonsils from those with symptomatic CMI. Further investigation is required to understand the importance of a shorter clivus length on CMI symptomatology and pathophysiology.

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Title: Clivus length distinguishes between asymptomatic healthy controls and symptomatic adult women with Chiari malformation type I
Authors: Blaise Simplice Talla Nwotchouang
Maggie S. Eppelheimer
Alaaddin Ibrahimy
James R. Houston
Dipankar Biswas
Richard Labuda
Jayapalli Rajiv Bapuraj
Philip A. Allen
David Frim
Francis Loth
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Chiari Malformation
Chiari Malformation
Published in: Neuroradiology / Issue 11/2020
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-020-02453-5

At a glance: The STEP trials

Springer Medicine

Clivus length distinguishes between asymptomatic healthy controls and symptomatic adult women with Chiari malformation type I

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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