Evidence map›Paper›PMID 42728458›Full record

ArticleNeurosurgical review2026

The symptom spectrum: preoperative symptom-related indicators of surgical outcomes for adult type 1 chiari malformation.

Amirhossein Akhavan-Sigari, David J Park, Ahed H Kattaa, Zane C Norville, Elaheh Shaghaghian, Shagun R Nasta, Muhammad Izhar, Yusuke S Hori, Robert Dodd, Gordon Li and 4 more

Abstract read
PubMed Publisher
In one paragraph

Article in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Amirhossein Akhavan-SigariDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
David J ParkDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA. djpark@stanford.edu.
Ahed H KattaaDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Zane C NorvilleDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Elaheh ShaghaghianDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Shagun R NastaDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Muhammad IzharDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Yusuke S HoriDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Robert DoddDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Gordon LiDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Cormac O MaherDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Lawrence ShuerDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Gary K SteinbergDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Steven D ChangDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chiari I malformation (C1M) may necessitate surgical decompression in adulthood due to the emergence of debilitating neurological symptoms. The outcomes of surgical management for C1M in the adult population are variable and predictive value of individual symptoms has been less extensively studied. A retrospective cohort study was conducted on adult patients (≥ 18 years) who underwent posterior fossa decompression surgery (PFDS) for C1M at our institution between 2004 and 2024. Univariate and multivariate analyses were performed to evaluate the predictive value of preoperative C1M-related symptoms on postoperative clinician-documented outcomes and complete symptom resolution at 30-, 90-day, and long-term follow-up. A total of 209 adult patients underwent PFDS for C1M, with a median age of 36 years and a male-to-female ratio of 1:4.9. Headache was the most common presenting symptom (91.4%), with tussive headaches present in 62.3% of cases with headache. Multivariate regression analysis identified preoperative sleep apnea (OR = 6.55, 95% CI: 1.16-37.05), imbalance (OR = 2.33, 95% CI: 1.12-4.84), and tinnitus (OR = 2.81, 95% CI: 1.14-6.89) as predictors of symptom improvement at 30-days follow-up, while dysphagia (OR = 5.80, 95% CI: 1.39-24.12) was predictive at 90-days. Patients with preoperative hearing loss were more likely to experience symptom recurrence during long-term follow-up (OR = 4.55, 95% CI: 1.04-19.77). Hand numbness/weakness and visual symptoms were the only two preoperative symptoms predictive of a lower odds of complete symptom resolution at the final follow-up (OR = 0.50 and OR = 0.42, respectively). Several clinical factors were associated with postoperative symptom outcomes after PFDS for C1M. These associations should be considered hypothesis-generating and require prospective validation before clinical application.

Indexed as

Arnold-Chiari MalformationDecompression, SurgicalAdolescentAdultCranial Fossa, PosteriorFemaleHeadacheHumansMaleMiddle AgedNeurosurgical ProceduresRetrospective StudiesTreatment OutcomeYoung AdultChiari malformationPainPosterior fossa decompressionTonsillar herniation

Identifiers

PMID42728458

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.