ArticleNeurosurgery2015
Imaging-Based Features of Headaches in Chiari Malformation Type I.
Article in Neurosurgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 34 citations in OpenAlex.
- Assessing the Diagnostic Value of Brain White Matter Hyperintensities and Clinical Symptoms in Predicting the Detection of CSF-Venous Fistula in Patients with Suspected Spontaneous Intracranial Hypotension.AJNR. American journal of neuroradiology · 2025Article
- Denervation of rectus capitis posterior minor as neglected factor in Chiari malformation type I revealed by double blinded prospective study.Scientific reports · 2025Article
- Pulsatile microvascular cerebral blood flow waveforms change with intracranial compliance and age.Neurophotonics · 2024Article
- Chiari Malformation Type 1 in Adults.Advances and technical standards in neurosurgery · 2023Article
- Diagnostic utility of parasagittal measurements of tonsillar herniation in Chiari I malformation.The neuroradiology journal · 2022Article
- Influence of Pain on Cognitive Dysfunction and Emotion Dysregulation in Chiari Malformation Type I.Advances in experimental medicine and biology · 2022Review
- The Need for Head Space: Brachycephaly and Cerebrospinal Fluid Disorders.Life (Basel, Switzerland) · 2021Review
- Clinical utility of 2-D anatomic measurements in predicting cough-associated headache in Chiari I malformation.Neuroradiology · 2020Article
- Comparing invasive with MRI-derived intracranial pressure measurements in healthy elderly and brain trauma cases: A pilot study.Journal of magnetic resonance imaging : JMRI · 2019Observational
- Epidemiology of Symptomatic Chiari Malformation in Tatarstan: Regional and Ethnic Differences in Prevalence.Neurosurgery · 2019Article
- Chiari Headache.Current pain and headache reports · 2018Review
- A Retrospective 2D Morphometric Analysis of Adult Female Chiari Type I Patients with Commonly Reported and Related Conditions.Frontiers in neuroanatomy · 2018Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundSuboccipital cough-induced headaches are considered a hallmark symptom of Chiari malformation type I (CMI). However, non--Valsalva-related suboccipital headaches and headaches in other locations are also common in CMI. The diagnostic significance and the underlying factors associated with these different headaches types are not well understood.
objectiveTo compare cranial morphology and hydrodynamics in 3 types of headaches in CMI to better understand the pathophysiological basis for the different headache characteristics.
methodsTwenty-two cranial physiological and morphological measures were obtained with specialized magnetic resonance imaging scans from 63 symptomatic pretreated CMI patients, 40 with suboccipital headaches induced by Valsalva maneuvers (34 women; age, 36 ± 10 years), 15 with non--Valsalva-related suboccipital headaches (10 women; age, 33 ± 9 years), 8 with nonsuboccipital non--Valsalva-induced headaches (8 women; age, 39 ± 13 years), and 37 control subjects (24 women; age, 36 ± 12 years). Group differences were identified with the use of the 2-tailed Student t test.
resultsPosterior cranial fossa markers of CMI were similar among the 3 headache subtypes. However, the Valsalva-related suboccipital headaches cohort demonstrated a significantly lower intracranial compliance index than the non--Valsalva-related suboccipital headaches cohort (7.5 ± 3.4 vs 10.9 ± 4.9), lower intracranial volume change during the cardiac cycle (0.48 ± 0.19 vs 0.61 ± 0.16 mL), and higher magnetic resonance imaging--derived intracranial pressure (11.1 ± 4.3 vs 7.7 ± 2.8 mm Hg; P = .02). The Valsalva-related suboccipital headaches cohort had smaller intracranial and lateral ventricular volumes compared with the healthy cohort. The non--Valsalva-related suboccipital headaches cohort had reduced venous drainage through the jugular veins.
conclusionValsalva-induced worsening of occipital headaches appears to be related to a small intracranial volume rather than the smaller posterior cranial fossa. This explains the reduced intracranial compliance and corresponding higher pressure measured in CMI patients with headaches affected by Valsalva maneuvers.
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