Cervico-medullary compression ratio: A novel radiological parameter correlating with clinical severity in Chiari type 1 malformation

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dc.authorid0000-0002-6983-8632
dc.contributor.authorDoruk, Ebru
dc.contributor.authorOzay, Rafet
dc.contributor.authorŞekerci, Zeki
dc.contributor.authorDurmaz, Hasan Ali
dc.contributor.authorGüneş, Serra Özbal
dc.contributor.authorHanalıoğlu, Şahin
dc.contributor.authorSorar, Mehmet
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:50:02Z
dc.date.available10.07.201910:49:13
dc.date.available2019-07-10T19:50:02Z
dc.date.issued2018
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Beyin ve Sinir Cerrahisi Ana Bilim Dalı
dc.descriptionWOS: 000450134600021
dc.descriptionPubMed ID: 30236638
dc.description.abstractObjectives: Chiari malformation type 1 (CM-1) is associated with cough headache, intracranial hypertension, cerebellar and spinal cord symptoms/signs. Herniated cerebellar tonsil length (HCTL) is widely used radiological parameter to determine the severity of CM-1, but with limited utility due to its weak correlation with some clinico-radiological findings. In this study, we aimed to evaluate a novel, practical parameter (cervico-medullary compression ratio; "CMCR") for its relationship with clinico-radiological findings in CM-1. Patients and methods: Thirty-five adult patients (17 F, 18 M) with CM-1 were included in this retrospective study. Head CT and craniospinal MR images were assessed. CMCR was calculated as the ratio of herniated cerebellar tonsil surface area to foramen magnum surface area, and HCTL was measured. These two parameters were correlated with clinical and radiological findings. Results: The mean CMCR was 0.60 +/- 0.15 and mean HCTL was 8.91 +/- 3.4 mm with no significant difference between gender and age groups for both parameters. For cough headache (0.64 +/- 0.14 vs 0.52 +/- 0.15, p = 0.043) and syringomyelia (0.67 +/- 0.11 vs 0.56 +/- 0.16, p = 0.039), only CMCR; for intracranial hypertension (CMCR: 0.64 +/- 0.14 vs 0.55 +/- 0.16, p = 0.049; HCTL: 9.66 +/- 3.59 mm vs 7.79 +/- 3.03 mm; p = 0.045) and cerebellar symptoms (CMCR: 0.65 +/- 0.14 vs 0.54 +/- 0.16, p = 0.048; HCTL: 10.4 +/- 3.5 mm vs 7.4 +/- 2.8 mm, p = 0.041), both CMCR and HTCL were significantly different between patients with and without respective findings. However, neither CMCR nor HTCL was different between patients with and without spinal cord symptoms and hydrocephalus. Conclusion: CMCR is a superior numerical parameter than HCTL for the assessment of clinical severity in CM-1 cases and needs further validation with larger studies.
dc.identifier.citationDoruk, E., Ozay, R., Şekerci, Z., Durmaz, H. A., Güneş, S. Ö., Hanalıoğlu, Ş. ... Sorar, M. (2018). Cervico-medullary compression ratio: A novel radiological parameter correlating with clinical severity in Chiari type 1 malformation, 174, 123-128. https://dx.doi.org/10.1016/j.clineuro.2018.09.016
dc.identifier.doi10.1016/j.clineuro.2018.09.016
dc.identifier.endpage128
dc.identifier.issn0303-8467
dc.identifier.issn1872-6968
dc.identifier.scopusqualityQ2
dc.identifier.startpage123
dc.identifier.urihttps://dx.doi.org/10.1016/j.clineuro.2018.09.016
dc.identifier.urihttps://hdl.handle.net/20.500.12511/1857
dc.identifier.volume174
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Science Bv
dc.relation.ispartofClinical Neurology and Neurosurgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectChiari Malformation
dc.subjectHerniated Cerebellar Tonsil
dc.subjectForamen Magnum
dc.subjectCervico-Medullary Compression Ratio
dc.subjectSyringomyelia
dc.subjectHydrocephalus
dc.titleCervico-medullary compression ratio: A novel radiological parameter correlating with clinical severity in Chiari type 1 malformation
dc.typeArticle

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