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<meta name="DC.Title" content="Effect of Craniocervical Decompression on Peak CSF Velocities in Symptomatic Patients with Chiari I Malformation" />
<meta name="DC.Date" content="2004-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Peak CSF velocities detected in individual voxels in the subarachnoid space in patients with Chiari I malformations exceed those in similar locations in the subarachnoid space in healthy subjects. The purpose of this study was to test the hypothesis that the peak voxel velocities are decreased by craniocervical decompression.

METHODS: A consecutive series of patients with symptomatic Chiari I malformations was studied before and after craniocervical decompression with cardiac-gated, phase contrast MR imaging. Velocities were calculated for each voxel within the foramen magnum at 14 time points throughout the cardiac cycle. The greatest velocities measured in a voxel during the cephalad and caudad phases of CSF flow through the foramen magnum were tabulated for each patient before and after surgery. The differences in these velocities between the preoperative and postoperative studies were tested for statistical significance by using a single-tailed Student’s t test of paired samples.

RESULTS: Eight patients with a Chiari I malformation, including four with a syrinx, were studied. Peak caudad velocity diminished after craniocervical decompression in six of the eight patients, and the average diminished significantly from 3.4 cm/s preoperatively to 2.4 cm/s postoperatively ( P = .01). Peak cephalad velocity diminished in six of the eight cases. The average diminished from 6.9 cm/s preoperatively to 3.9 cm/s postoperatively, a change that nearly reached the significance level of .05 ( P = .055).

CONCLUSION: Craniocervical decompression in patients with Chiari I malformations decreases peak CSF velocities in the foramen magnum. The study supports the hypothesis that successful treatment of the Chiari I malformation is associated with improvement in CSF flow patterns." />
<meta name="DC.Contributor" content="Maria T. Dolar" />
<meta name="DC.Contributor" content="Victor M. Haughton" />
<meta name="DC.Contributor" content="Bermans J. Iskandar" />
<meta name="DC.Contributor" content="Mark Quigley" />
<meta name="article:published_time" content="2004-01-01" />
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<meta name="citation_title" content="Effect of Craniocervical Decompression on Peak CSF Velocities in Symptomatic Patients with Chiari I Malformation" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; Peak CSF velocities detected in individual voxels in the subarachnoid space in patients with Chiari I malformations exceed those in similar locations in the subarachnoid space in healthy subjects. The purpose of this study was to test the hypothesis that the peak voxel velocities are decreased by craniocervical decompression.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; A consecutive series of patients with symptomatic Chiari I malformations was studied before and after craniocervical decompression with cardiac-gated, phase contrast MR imaging. Velocities were calculated for each voxel within the foramen magnum at 14 time points throughout the cardiac cycle. The greatest velocities measured in a voxel during the cephalad and caudad phases of CSF flow through the foramen magnum were tabulated for each patient before and after surgery. The differences in these velocities between the preoperative and postoperative studies were tested for statistical significance by using a single-tailed Student’s &lt;i&gt;t&lt;/i&gt; test of paired samples.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; Eight patients with a Chiari I malformation, including four with a syrinx, were studied. Peak caudad velocity diminished after craniocervical decompression in six of the eight patients, and the average diminished significantly from 3.4 cm/s preoperatively to 2.4 cm/s postoperatively (&lt;i&gt;P&lt;/i&gt; = .01). Peak cephalad velocity diminished in six of the eight cases. The average diminished from 6.9 cm/s preoperatively to 3.9 cm/s postoperatively, a change that nearly reached the significance level of .05 (&lt;i&gt;P&lt;/i&gt; = .055).&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; Craniocervical decompression in patients with Chiari I malformations decreases peak CSF velocities in the foramen magnum. The study supports the hypothesis that successful treatment of the Chiari I malformation is associated with improvement in CSF flow patterns.&lt;/p&gt;" />
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<meta name="citation_author" content="Maria T. Dolar" />
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<meta name="citation_reference" content="citation_title=Neurosurgery;citation_journal_abbrev=Neurosurgery;citation_title=Quantitative cine-mode magnetic resonance imaging of Chiari I malformations: an analysis of cerebrospinal fluid dynamics.;citation_pages=214-223;citation_volume=35;citation_year=1994;citation_issue=2;citation_pmid=7969828;citation_doi=10.1227/00006123-199408000-00006" />
<meta name="citation_reference" content="citation_title=Radiology;citation_journal_abbrev=Radiology;citation_title=Cerebrospinal fluid flow waveforms: analysis in patients with Chiari I malformation by means of gated phase-contrast MR imaging velocity measurements [published erratum appears in Radiology 1995 Sep;196(3):800];citation_pages=195-202;citation_volume=196;citation_year=1995;citation_issue=1;citation_issn=0033-8419;citation_pmid=7784567" />
<meta name="citation_reference" content="citation_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_title=Phase-Contrast MR Imaging of the Cervical CSF and Spinal Cord: Volumetric Motion Analysis in Patients with Chiari I Malformation;citation_pages=151-158;citation_volume=21;citation_year=2000;citation_issue=1;citation_issn=0195-6108;citation_pmid=10669242" />
<meta name="citation_reference" content="citation_title=Journal of neurosurgery;citation_journal_abbrev=J Neurosurg;citation_title=Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils. Implications for diagnosis and treatment.;citation_pages=3-15;citation_volume=80;citation_year=1994;citation_issue=1;citation_pmid=8271018" />
<meta name="twitter:title" content="Effect of Craniocervical Decompression on Peak CSF Velocities in Symptomatic Patients with Chiari I Malformation" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Peak CSF velocities detected in individual voxels in the subarachnoid space in patients with Chiari I malformations exceed those in similar locations in the subarachnoid space in healthy subjects. The purpose of this study was to test the hypothesis that the peak voxel velocities are decreased by craniocervical decompression.

METHODS: A consecutive series of patients with symptomatic Chiari I malformations was studied before and after craniocervical decompression with cardiac-gated, phase contrast MR imaging. Velocities were calculated for each voxel within the foramen magnum at 14 time points throughout the cardiac cycle. The greatest velocities measured in a voxel during the cephalad and caudad phases of CSF flow through the foramen magnum were tabulated for each patient before and after surgery. The differences in these velocities between the preoperative and postoperative studies were tested for statistical significance by using a single-tailed Student’s t test of paired samples.

RESULTS: Eight patients with a Chiari I malformation, including four with a syrinx, were studied. Peak caudad velocity diminished after craniocervical decompression in six of the eight patients, and the average diminished significantly from 3.4 cm/s preoperatively to 2.4 cm/s postoperatively ( P = .01). Peak cephalad velocity diminished in six of the eight cases. The average diminished from 6.9 cm/s preoperatively to 3.9 cm/s postoperatively, a change that nearly reached the significance level of .05 ( P = .055).

CONCLUSION: Craniocervical decompression in patients with Chiari I malformations decreases peak CSF velocities in the foramen magnum. The study supports the hypothesis that successful treatment of the Chiari I malformation is associated with improvement in CSF flow patterns." />
<meta name="og-title" property="og:title" content="Effect of Craniocervical Decompression on Peak CSF Velocities in Symptomatic Patients with Chiari I Malformation" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/25/1/142" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Peak CSF velocities detected in individual voxels in the subarachnoid space in patients with Chiari I malformations exceed those in similar locations in the subarachnoid space in healthy subjects. The purpose of this study was to test the hypothesis that the peak voxel velocities are decreased by craniocervical decompression.

METHODS: A consecutive series of patients with symptomatic Chiari I malformations was studied before and after craniocervical decompression with cardiac-gated, phase contrast MR imaging. Velocities were calculated for each voxel within the foramen magnum at 14 time points throughout the cardiac cycle. The greatest velocities measured in a voxel during the cephalad and caudad phases of CSF flow through the foramen magnum were tabulated for each patient before and after surgery. The differences in these velocities between the preoperative and postoperative studies were tested for statistical significance by using a single-tailed Student’s t test of paired samples.

RESULTS: Eight patients with a Chiari I malformation, including four with a syrinx, were studied. Peak caudad velocity diminished after craniocervical decompression in six of the eight patients, and the average diminished significantly from 3.4 cm/s preoperatively to 2.4 cm/s postoperatively ( P = .01). Peak cephalad velocity diminished in six of the eight cases. The average diminished from 6.9 cm/s preoperatively to 3.9 cm/s postoperatively, a change that nearly reached the significance level of .05 ( P = .055).

CONCLUSION: Craniocervical decompression in patients with Chiari I malformations decreases peak CSF velocities in the foramen magnum. The study supports the hypothesis that successful treatment of the Chiari I malformation is associated with improvement in CSF flow patterns." />
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      <h1 class="highwire-cite-title" id="page-title">Effect of Craniocervical Decompression on Peak CSF Velocities in Symptomatic Patients with Chiari I Malformation</h1>  
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               <h2>Supplemental Material - Dolar, M. T. et al.</h2>
               <p>Supplemental material for Dolar, MT, Haughton, VM, Iskandar, BJ, Quigley, M, et al. <strong>Effect of Craniocervical Decompression on Peak CSF Velocities in Symptomatic Patients with Chiari I Malformation</strong>.  <em>AJNR Am J Neuroradiol</em> 2004;25:142-145 
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               <p><strong>Note: Microsoft PowerPoint is required to view cine loops file and the Adobe Acrobat Reader is required to view tables and
                     is available for free download at http://www.adobe.com/products/acrobat/readstep2.html</strong></p>
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                     		Table 1: Preoperative characteristics of eight patients who underwent craniocervical decompression.
                     Table 2: Outcomes of eight patients who underwent craniocervical decompression.
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                     		Cine Loops of normal subject patient and postoperative patients.  The first two slides show a normal and a patients.  The
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