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Floyd H. Gilles and Robin I. Davidson

relationships to the lateral lacunae or sagittal sinus. 6 One case of acquired aqueductal stenosis secondary to a mesencephalic tectal glioma failed to show any change in number or size. 6 Furthermore, arachnoidal granulations were present in cases with shunts in place for long periods of time in which the hydrocephalus was related to a Chiari I malformation, postmeningitic leptomeningeal fibrosis, arteriovenous malformation, and multiple cases of tumor including medulloblastoma and diencephalic glioma. 6 Conclusions While it is clear that the abnormality of

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Keasley Welch, John Shillito, Roy Strand, Edwin G. Fischer and Ken R. Winston

✓ Caudal herniation of the hindbrain, indistinguishable from the Chiari I deformity, may occur after the establishment of spinal subarachnoid shunts and become symptomatic years after the procedure. Examples are presented and others are cited from the literature. It is proposed that the force responsible for the displacement is the difference in pressure between the cranial and spinal compartments. On the basis of these observations and other considerations as well, a similar process, disproportionate absorption of cerebrospinal fluid from the spinal region, might account for the spontaneous form of the Chiari I deformity.

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.3171/jns.1981.55.4.0590 Chiari Imalformation”—an acquired disorder? Keasley Welch John Shillito Roy Strand Edwin G. Fischer Ken R. Winston October 1981 55 4 604 609 10.3171/jns.1981.55.4.0604 Cardiac catheters for diagnosis and treatment of venous air embolism Robert F. Bedford Wayne K. Marshall Albert Butler Joseph E. Welsh October 1981 55 4 610 614 10.3171/jns.1981.55.4.0610 Cerebellar metastasis from a prolactinoma during treatment with bromocriptine Neil A. Martin Martha Hales Charles B. Wilson October 1981 55 4 615 619 10.3171/jns.1981

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56 3 368 372 10.3171/jns.1982.56.3.0368 Use of metrizamide in computerized tomography to diagnose the Chiari I malformation Ronald E. Woosley Robert A. Whaley March 1982 56 3 373 376 10.3171/jns.1982.56.3.0373 Definitive radiation therapy for chordoma and chondrosarcoma of base of skull and cervical spine Herman D. Suit Michael Goitein John Munzenrider Lynn Verhey Kenneth R. Davis Andreas Koehler Rita Linggood Robert G. Ojemann March 1982 56 3 377 385 10.3171/jns.1982.56.3.0377 Liquid crystal thermography of the spine and extremities Rubem Pochaczevsky

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Ronald E. Woosley and Robert A. Whaley

T he Chiari I malformation consists of variable downward displacement of the cerebellar tonsils without an associated myelomeningocele. 7, 8 In some cases, cervical spine anomalies may be present. 1 Syringohydromyelia may occur as a result of poor fourth ventricular outflow; significant ventricular enlargement is rare. 3, 4 Prior to the introduction of computerized tomography (CT), the neuroradiological evaluation of this condition at our institution usually consisted of cerebral angiography to assess ventricular size and the position of the cerebellar

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Leslie D. Cahan and John R. Bentson

was noted to be smaller than normal. It was often so small that the radiographic appearance was diagnostic of syringomyelia. In our experience, no pathological condition other than severe spinal cord trauma is capable of producing a cord with such a narrow sagittal diameter as is seen with a collapsed syrinx. Air studies with the patient in the seated position also gave the best information regarding the anatomy at the foramen magnum, the presence of low tonsils or webs, and the appearance and degree of communication of the ventricular system. Chiari I malformations

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Arnold-Chiari malformation

Review of 71 cases

Kamal S. Paul, Richard H. Lye, F. Alexander Strang and John Dutton

, Shillito J , Strand R , et al : Chiari Imalformation” — an acquired disorder? J Neurosurg 55 : 604 – 609 , 1981 Welch K, Shillito J, Strand R, et al: Chiari Imalformation” — an acquired disorder? J Neurosurg 55: 604–609, 1981 30. Williams B : A critical appraisal of posterior fossa surgery for communicating syringomyelia. Brain 101 : 223 – 250 , 1978 Williams B: A critical appraisal of posterior fossa surgery for communicating syringomyelia. Brain 101: 223–250, 1978

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Surgical treatment of syringomyelia

Favorable results with syringoperitoneal shunting

Nicholas M. Barbaro, Charles B. Wilson, Philip H. Gutin and Michael S. B. Edwards

syrinxes ( Fig. 2 right ) and allowed the operative approach to be directed to the largest portion of the syrinx, where the spinal cord was thinnest. Fig. 2. Left: Sagittal reconstruction of postmetrizamide computerized tomography (CT) scan showing tonsillar ectopia in a patient with Chiari I malformation. Right: Axial postmetrizamide CT scan showing an eccentrically placed cervical syrinx. Percutaneous injection of metrizamide into a syrinx was followed by plain radiography and CT scanning in six patients ( Fig. 3 ). This technique revealed the

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Joan L. Venes, Keith L. Black and Joseph T. Latack

more severe type of abnormality in whom the malformed brain stem might have a low threshold for injury from pressure. We broadened our indications for surgery to include those commonly used in evaluating patients with Arnold-Chiari I malformation: namely, progressive spasticity and upper-extremity weakness as well as the more widely accepted respiratory and swallowing dysfunction. A recent paper by Park, et al. , 10 documents the beneficial results in eight of 12 patients with progressive spasticity and upper-arm weakness in whom “posterior fossa decompression” was

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Chiari I malformation with syringomyelia

Evaluation of surgical therapy by magnetic resonance imaging

Ulrich Batzdorf

T he advent of new imaging techniques in the past decade (in particular, computerized tomographic scanning with injection of water-soluble contrast medium and magnetic resonance (MR) imaging) has greatly facilitated the diagnosis of Chiari I malformation and associated syringomyelia. Indeed, MR imaging has now become the optimal technique, since it is noninvasive and permits simultaneous studies of the brain, craniocervical junction, and spinal cord. 2 As a result, this disease complex, once thought to be quite rare, is now being diagnosed with increased