ArticleNeurologia medico-chirurgica2022
Surgical Management of Chiari Malformation Type I and Instability of the Craniocervical Junction Based on Its Pathogenesis and Classification.
Article in Neurologia medico-chirurgica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Redefining Chiari Malformation Type III: a systematic review of prognostic stratification based on a three-tier MRI-based anatomical classification.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Pooled it
- The role of tonsillar manipulation in posterior fossa decompression for Chiari I malformation: a 26-year institutional experience.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- MRI-morphometric characterization of Chiari malformation types 0 and 1 with syringomyelia: implications for diagnosis and pathogenesis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Observational
- Chiari Malformation and Hindbrain Descent: Characterization and New Classification Based on Mechanism and Pathogenesis, and Surgical Management.Neurospine · 2025Article
- Differentiating the Structural and Functional Instability of the Craniocervical Junction.Healthcare (Basel, Switzerland) · 2024Review
- Comprehensive comparative study of Chiari-like malformation in veterinary and human medicine.Veterinarni medicina · 2024Review
- Article
- Scoliosis in adult Type 1 Chiari malformation with syringomyelia patients: from pathogenesis to treatment.American journal of translational research · 2024Review
- Evaluation and Treatment of Patients with Small Posterior Cranial Fossa and Chiari Malformation, Types 0 and 1.Advances and technical standards in neurosurgery · 2024Article
- Article
- Treatment of Chiari malformations with craniovertebral junction anomalies: Where do we stand today?World neurosurgery: X · 2023Article
- The effectiveness of optic nerve sheath diameter in surgical decision-making for type I Chiari malformations.Journal of craniovertebral junction & spineArticle
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We investigated the mechanism underlying Chiari malformation type I (CM-I) and classified it according to the morphometric analyses of posterior cranial fossa (PCF) and craniocervical junction (CCJ). Three independent subtypes of CM-I were confirmed (CM-I types A, B, and C) for 484 cases and 150 normal volunteers by multiple analyses. CM-I type A had normal volume of PCF (VPCF) and occipital bone size. Type B had normal VPCF and small volume of the area surrounding the foramen magnum (VAFM) and occipital bone size. Type C had small VPCF, VAFM, and occipital bone size. Morphometric analyses during craniocervical traction test demonstrated instability of CCJ. Foramen magnum decompression (FMD) was performed in 302 cases. Expansive suboccipital cranioplasty (ESCP) was performed in 102 cases. Craniocervical posterolateral fixation (CCF) was performed for CCJ instability in 70 cases. Both ESCP and FMD showed a high improvement rate of neurological symptoms and signs (84.4%) and a high recovery rate of the Japanese Orthopaedic Association (JOA) score (58.5%). CCF also showed a high recovery rate of the JOA score (69.7%), with successful joint stabilization (84.3%). CM-I type A was associated with other mechanisms that caused ptosis of the brainstem and cerebellum (CCJ instability and traction and pressure dissociation between the intracranial cavity and spinal canal cavity), whereas CM-I types B and C demonstrated underdevelopment of the occipital bone. For CM-I types B and C, PCF decompression should be performed, whereas for small VPCF, ESCP should be performed. CCF for CCJ instability (including CM-I type A) was safe and effective.
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