Evidence map›Paper›PMID 38394661›Full record

ArticleJournal of neurosurgery. Pediatrics2024

Multicenter comparison of Chiari malformation type I presentation in children versus adults.

Armin Mortazavi, Neil D Almeida, Katherine Hofmann, Laurence Davidson, Juliana Rotter, Tiffany N Phan, Deki Tsering, Christina Maxwell, Jehshua Karunakaran, Erol Veznedaroglu and 10 more

Abstract readMulticenter StudyComparative Study
In one paragraph

Article in Journal of neurosurgery. Pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors.

Armin Mortazavi1Georgetown University School of Medicine, Washington, DC.
Neil D Almeida2George Washington University School of Medicine and Health Sciences, Washington, DC.
Katherine Hofmann3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
Laurence Davidson3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
Juliana Rotter1Georgetown University School of Medicine, Washington, DC.
Tiffany N Phan3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
Deki Tsering3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
Christina Maxwell5Global Neurosciences Institute, Philadelphia, Pennsylvania.
Jehshua Karunakaran2George Washington University School of Medicine and Health Sciences, Washington, DC.
Erol Veznedaroglu5Global Neurosciences Institute, Philadelphia, Pennsylvania.
Anthony J Caputy2George Washington University School of Medicine and Health Sciences, Washington, DC.
John D Heiss6Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
Faheem A Sandhu7Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC; and.
John S Myseros3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
Chima Oluigbo3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
Suresh N Magge3Division of Neurosurgery, Children's National Medical Center, Washington, DC.
Donald C Shields2George Washington University School of Medicine and Health Sciences, Washington, DC.
Michael K Rosner2George Washington University School of Medicine and Health Sciences, Washington, DC.
Grégoire P Chatain8Department of Neurosurgery, University of Colorado, Aurora, Colorado.
Robert F Keating3Division of Neurosurgery, Children's National Medical Center, Washington, DC.

Funding

Pathophysiology and Treatment of SyringomyeliaZIANS003050 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI HEISS, JOHN · 2009 to 2025
$14.4M
Intramural NIH HHS ZIA NS003050
6 · The paper itself

Abstract

objectiveTreatment for Chiari malformation type I (CM-I) often includes surgical intervention in both pediatric and adult patients. The authors sought to investigate fundamental differences between these populations by analyzing data from pediatric and adult patients who required CM-I decompression.

methodsTo better understand the presentation and surgical outcomes of both groups of patients, retrospective data from 170 adults and 153 pediatric patients (2000-2019) at six institutions were analyzed.

resultsThe adult CM-I patient population requiring surgical intervention had a greater proportion of female patients than the pediatric population (p < 0.0001). Radiographic findings at initial clinical presentation showed a significantly greater incidence of syringomyelia (p < 0.0001) and scoliosis (p < 0.0001) in pediatric patients compared with adult patients with CM-I. However, presenting signs and symptoms such as headaches (p < 0.0001), ocular findings (p = 0.0147), and bulbar symptoms (p = 0.0057) were more common in the adult group. After suboccipital decompression procedures, 94.4% of pediatric patients reported symptomatic relief compared with 75% of adults with CM-I (p < 0.0001).

conclusionsHere, the authors present the first retrospective evaluation comparing adult and pediatric patients who underwent CM-I decompression. Their analysis reveals that pediatric and adult patients significantly differ in terms of demographics, radiographic findings, presentation of symptoms, surgical indications, and outcomes. These findings may indicate different clinical conditions or a distinct progression of the natural history of this complex disease process within each population, which will require prospective studies to better elucidate.

Indexed as

Arnold-Chiari MalformationDecompression, SurgicalAdolescentAdultAge FactorsChildChild, PreschoolFemaleHumansMaleMiddle AgedRetrospective StudiesScoliosisSyringomyeliaTreatment OutcomeYoung AdultChiari malformationCSFspinal cordsyringomyeliasyrinx

Identifiers

PMID38394661
PMCPMC11369763

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.