Evidence map›Paper›PMID 41486256›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026

Preoperative radiological scoring system in Chiari malformation type 1: a surgical guide.

Neetika Gupta, Maria Dien Esquivel, Rajat Khurana, Debajyoti Datta, Bijelic Vid, Nick Barrowman, Albert Tu, Nagwa Wilson

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Neetika GuptaDepartment of Medical Imaging, CHEO, University of Ottawa, Ottawa, ON, Canada. NGupta@cheo.on.ca.
Maria Dien EsquivelDepartment of Diagnostic and Interventional Radiology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Rajat KhuranaDepartment of Medical Imaging, CHEO, University of Ottawa, Ottawa, ON, Canada.
Debajyoti DattaDepartment of Neurosurgery, CHEO, University of Ottawa, Ottawa, ON, Canada.
Bijelic VidCHEO Research Institute, CHEO, Ottawa, Canada.
Nick BarrowmanCHEO Research Institute, CHEO, Ottawa, Canada.
Albert TuDepartment of Neurosurgery, CHEO, University of Ottawa, Ottawa, ON, Canada.
Nagwa WilsonDepartment of Medical Imaging, CHEO, University of Ottawa, Ottawa, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChiari I malformation (CM1) is often incidentally detected on neuroimaging, with a minority of cases requiring intervention. There remain variability in the available guidelines for predicting surgery in pediatric CM1 patients. The study sought to design a preoperative scoring system using key radiological factors to anticipate likelihood of surgery in pediatric CM1 patients.

methodsA retrospective single-center study examining 122 CM1 patients identified between January 2007 to February 2020 was carried out. Radiological parameters associated with surgery as an outcome vs no surgery were collected and analyzed to develop a preoperative scoring system.

resultsThe statistically significant radiological parameters associated with surgical intervention include herniated tonsil ≥ 1 cm (85.2%), obex below McRae's line (70.4%), dilated central canal and syrinx (63.0%) and medullary kinking (51.9%). These variables were scrutinized for predictiveness in developing a 10-point preoperative scoring system.

conclusionThis study highlights the association of herniated tonsil, syrinx and medullary kinking with surgery as outcome. The proposed scoring system combining these imaging features shows increasing surgery probability with higher scores, reaching 100% at score of 10 and 50% at score of 4. This system may aid in triage, screening and prioritizing the patients for urgent neurosurgical referral or for conservative management.

Indexed as

Arnold-Chiari MalformationNeurosurgical ProceduresPreoperative CareAdolescentChildChild, PreschoolFemaleHumansInfantMagnetic Resonance ImagingMaleNeuroimagingRetrospective StudiesChiari I malformationHerniated tonsilKinking of medullaObex positionSurgical interventionSyrinx

Identifiers

PMID41486256

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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.