Distribution of cerebellar tonsil position: implications for understanding Chiari malformation.

Abstract:

OBJECT:Prior attempts to define normal cerebellar tonsil position have been limited by small numbers of patients precluding analysis of normal distribution by age group. The authors' objective in the present study was to analyze cerebellar tonsil location in every age range. METHODS:Two thousand four hundred patients were randomly selected from a database of 62,533 consecutive patients undergoing MRI and were organized into 8 age groups. Magnetic resonance images were directly examined for tonsil location, morphology, and other features. Patients with a history or imaging findings of posterior fossa abnormalities unrelated to Chiari malformation (CM) were excluded from analysis. The caudal extent of the cerebellar tonsils was measured at the midsagittal and lowest parasagittal positions. RESULTS:The mean tonsil height decreased slightly with advancing age into young adulthood and increased with advancing age in the adult age range. An increasing age in the adult age range was associated with a decreased likelihood of a tonsil position 5 mm or more below the foramen magnum (p = 0.0004). In general, the lowest tonsil position in each age group was normally distributed. Patients with pegged morphology were more likely to have a tonsil location at least 5 mm below the foramen magnum (85%), as compared with those having intermediate (38%) or rounded (2%) morphology (p < 0.0001). Female sex was associated with a lower mean tonsil position (p < 0.0001). Patients with a lower tonsil position also tended to have an asymmetrical tonsil position, usually lower on the right (p < 0.0001). CONCLUSIONS:Cerebellar tonsil position follows an essentially normal distribution and varies significantly by age. This finding has implications for advancing our understanding of CM.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Smith BW,Strahle J,Bapuraj JR,Muraszko KM,Garton HJ,Maher CO

doi

10.3171/2013.5.JNS121825

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

812-9

issue

3

eissn

0022-3085

issn

1933-0693

journal_volume

119

pub_type

杂志文章
  • Results of nerve grafting in radial nerve injuries occurring proximal to the humerus, including those within the posterior cord.

    abstract::OBJECTIVE Results of radial nerve grafting are largely unknown for lesions of the radial nerve that occur proximal to the humerus, including those within the posterior cord. METHODS The authors describe 13 patients with proximal radial nerve injuries who were surgically treated and then followed for at least 24 months...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2014.12.JNS141944.test

    authors: Bertelli JA,Ghizoni MF

    更新日期:2016-01-01 00:00:00

  • Indications for nonoperative treatment of spinal cord compression due to breast cancer.

    abstract::A retrospective series of 12,478 patients with breast cancer included 2467 patients with spinal metastases. Local treatment was not necessary in 688 patients. Neurological dificit did not develop in 1735 patients who underwent radiotherapy. Forty-four patients developed myelopathy due to spinal cord compression as dem...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1977.47.5.0653

    authors: Cobb CA 3rd,Leavens ME,Eckles N

    更新日期:1977-11-01 00:00:00

  • The Journal of Neurosurgery in the computer era.

    abstract::The fourth Editor of the Journal of Neurosurgery offers short vignettes on the Editors who preceded and succeeded him. He recounts some of the challenges that were faced and changes that were made during his time as Editor. One of the major changes was production of the Journal via computer. ...

    journal_title:Journal of neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.3171/jns.1994.81.1.0147

    authors: Collins WF

    更新日期:1994-07-01 00:00:00

  • The pineal gland: anatomy, physiology, and clinical significance.

    abstract::Since the discovery of melatonin approximately 25 years ago, there has been intense study regarding the details of the structure and function of the pineal gland. This work is reviewed, with particular emphasis on those aspects of importance to human physiology and disease. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/jns.1985.63.3.0321

    authors: Erlich SS,Apuzzo ML

    更新日期:1985-09-01 00:00:00

  • Magnetic resonance imaging of obliterated arteriovenous malformations up to 23 years after radiosurgery.

    abstract::The authors report outcomes in 18 patients with arteriovenous malformations (AVMs) who were treated with gamma knife radiosurgery and in whom magnetic resonance (MR) imaging was obtained a mean of 14 years (range 8-23 years) after treatment and 10 years (range 4-17 years) after confirmed obliteration of the AVM. All p...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1997.86.4.0589

    authors: Kihlström L,Guo WY,Karlsson B,Lindquist C,Lindqvist M

    更新日期:1997-04-01 00:00:00

  • Diagnosis and treatment of vertebral aneurysms.

    abstract::The intracranial vertebral artery and its branches are a common site of aneurysms in the posterior fossa. Ninety-four aneurysms in 86 patients were analyzed for their clinical manifestation, diagnosis, and treatment. There were three distinct varieties of aneurysm in this group: 56 (60%) saccular aneurysms, 26 (28%) d...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1988.69.3.0345

    authors: Yamaura A

    更新日期:1988-09-01 00:00:00

  • Carotid cave aneurysms of the internal carotid artery.

    abstract::In a series of 32 surgical cases of carotid-ophthalmic artery aneurysm, seven of the lesions were located in the "carotid cave." This special type of aneurysm is usually small and projects medially on the anteroposterior view of the angiogram. At surgery, it is located intradurally at the dural penetration of the inte...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1989.70.2.0216

    authors: Kobayashi S,Kyoshima K,Gibo H,Hegde SA,Takemae T,Sugita K

    更新日期:1989-02-01 00:00:00

  • Surgical seeding of chordomas.

    abstract:OBJECT:Chordomas have a high propensity for local recurrence and progression, as well as for systemic and cerebrospinal fluid metastasis. The authors identified and analyzed a series of patients with chordomas, focusing on an underrecognized pathological entity-surgical seeding of tumor cells. METHODS:In a retrospecti...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2001.95.5.0798

    authors: Arnautović KI,Al-Mefty O

    更新日期:2001-11-01 00:00:00

  • Monitoring of autoregulation using laser Doppler flowmetry in patients with head injury.

    abstract::The authors studied 31 comatose head-injured patients to assess the clinical usefulness of laser Doppler flowmetry (LDF) in continuous autoregulation monitoring. The LDF probes were placed on the surface of the cerebral cortex. Data on LDF, intracranial pressure (ICP), and arterial blood pressure (ABP) were recorded a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1997.86.3.0438

    authors: Lam JM,Hsiang JN,Poon WS

    更新日期:1997-03-01 00:00:00

  • Reversal of experimental delayed cerebral vasospasm by angiotensin-converting enzyme inhibition.

    abstract::Delayed cerebral vasospasm is an important determinant of the clinical outcome after subarachnoid hemorrhage, but its prevention and treatment has met with limited success. Since cerebral arteries were found to be sensitive to the vasoconstrictor effect of angiotensin II, the possibility of angiotensin's contribution ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.55.6.0884

    authors: Gavras H,Andrews P,Papadakis N

    更新日期:1981-12-01 00:00:00

  • Does size matter? Investigating the optimal planning target volume margin for postoperative stereotactic radiosurgery to resected brain metastases.

    abstract:OBJECTIVE:The optimal margin size in postoperative stereotactic radiosurgery (SRS) for brain metastases is unknown. Herein, the authors investigated the effect of SRS planning target volume (PTV) margin on local recurrence and symptomatic radiation necrosis postoperatively. METHODS:Records of patients who received pos...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2017.9.JNS171735

    authors: Jhaveri J,Chowdhary M,Zhang X,Press RH,Switchenko JM,Ferris MJ,Morgan TM,Roper J,Dhabaan A,Elder E,Eaton BR,Olson JJ,Curran WJ,Shu HG,Crocker IR,Patel KR

    更新日期:2018-04-20 00:00:00

  • Recurrent intracranial Masson's vegetant intravascular hemangioendothelioma. Case report and review of the literature.

    abstract::In the central nervous system, recurrence of intracranial Masson's vegetant intravascular hemangioendothelioma (MVIH) is rare. To the authors' knowledge, only three recurrent intracranial cases have been reported. The authors report the case of a 75-year-old woman with a recurrent left-sided cerebellopontine angle and...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/jns.1999.91.2.0308

    authors: Avellino AM,Grant GA,Harris AB,Wallace SK,Shaw CM

    更新日期:1999-08-01 00:00:00

  • A frameless stereotaxic integration of computerized tomographic imaging and the operating microscope.

    abstract::A computer-based system has been developed for the integration and display of computerized tomography (CT) image data in the operating microscope in the correct perspective without requiring a stereotaxic frame. Spatial registration of the CT image data is accomplished by determination of the position of the operating...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.65.4.0545

    authors: Roberts DW,Strohbehn JW,Hatch JF,Murray W,Kettenberger H

    更新日期:1986-10-01 00:00:00

  • Imaging studies of cerebral hyperperfusion after carotid endarterectomy. Case report.

    abstract::A case is reported of severe unilateral hemispheric edema and localized hemorrhage associated with seizures following endarterectomy of an ipsilateral high-grade carotid stenosis. Imaging studies including angiography, computerized tomography (CT), magnetic resonance imaging/angiography, and xenon-CT, suggested postop...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1995.83.1.0133

    authors: Penn AA,Schomer DF,Steinberg GK

    更新日期:1995-07-01 00:00:00

  • Supratentorial ependymomas. Neuroimaging and clinicopathological correlation.

    abstract::In 10 patients with supratentorial ependymomas, the tumors exhibited hyperdensity on computerized tomography (CT) scanning prior to contrast infusion and, with one exception, all tumors were mixed lesions with the low densities suggesting cystic or necrotic portions. Eighty percent of the tumors contained small calcif...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.64.2.0209

    authors: Centeno RS,Lee AA,Winter J,Barba D

    更新日期:1986-02-01 00:00:00

  • Apparent diffusion coefficients for evaluation of the response of brain tumors treated by Gamma Knife surgery.

    abstract:OBJECT:Cellular density is a major factor for change in the apparent diffusion coefficient (ADC). The authors hypothesized that loss of tumor cells after Gamma Knife surgery (GKS) may alter the ADC value and used diffusion weighted MR imaging (DW imaging) to evaluate cellular changes in brain tumors to detect their tre...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Huang CF,Chiou SY,Wu MF,Tu HT,Liu WS,Chuang JC

    更新日期:2010-12-01 00:00:00

  • Hemiparesis caused by vertebral artery compression of the medulla oblongata. Case report.

    abstract::The case is reported of a patient with progressive left hemiparesis due to vascular compression of the medulla oblongata. Metrizamide computerized tomography cisternography revealed that the left vertebral artery was compressing and distorting the left lateral surface of the medulla. Compression was surgically relieve...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1985.62.3.0425

    authors: Kim P,Ishijima B,Takahashi H,Shimizu H,Yokochi M

    更新日期:1985-03-01 00:00:00

  • Chemotherapy of pediatric brain-stem tumors.

    abstract::Forty-five children harboring brain-stem tumors were treated at the University of California, San Francisco, between 1969 and 1979. Pathological diagnoses were made in 19 patients. All patients received radiation therapy (RT). Thirteen patients received chemotherapy before, during, or immediately after RT. Twenty-four...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.54.6.0721

    authors: Fulton DS,Levin VA,Wara WM,Edwards MS,Wilson CB

    更新日期:1981-06-01 00:00:00

  • Reduction of cellular energy requirements. Screening for agents that may protect against CNS ischemia.

    abstract::Protection of the brain and spinal cord against ischemia is a goal of vast clinical importance. One approach to this objective is to reduce the tissue's functional activity in order to preserve energy for the metabolic processes that are essential to viability. Experiments to explore ways of reducing function-related ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1988.69.4.0568

    authors: Zager EL,Ames A 3rd

    更新日期:1988-10-01 00:00:00

  • Fracture of S1-2 after L4-S1 decompression and fusion. Case report and review of the literature.

    abstract::The author describes a woman in whom an S1-2 fracture developed after L4-S1 decompression and fusion. Osteoporosis was not present, but the lesion failed to respond to conservative therapy, necessitating surgical extension of the spinal fusion. Although biomechanical complications of lumbosacral fusion are uncommon, p...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2003.99.3.0310

    authors: Bose B

    更新日期:2003-10-01 00:00:00

  • Endolymphatic sac tumor demonstrated by intralabyrinthine hemorrhage. Case report.

    abstract::Endolymphatic sac tumors (ELSTs) are locally invasive neoplasms that arise in the posterior petrous bone and are associated with von Hippel-Lindau (VHL) disease. These tumors cause symptoms even when microscopic in size (below the threshold for detectability on imaging studies) and can lead to symptoms such as hearing...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/JNS-07/08/0421

    authors: Jagannathan J,Butman JA,Lonser RR,Vortmeyer AO,Zalewski CK,Brewer C,Oldfield EH,Kim HJ

    更新日期:2007-08-01 00:00:00

  • Modulation of phorbol ester-induced regulation of matrix metalloproteinases and tissue inhibitors of metalloproteinases by SB203580, a specific inhibitor of p38 mitogen-activated protein kinase.

    abstract:OBJECT:Expression of matrix metalloproteinases (MMPs) has been postulated to play a central role in brain tumor invasion; however, its underlying mechanism is not yet fully understood. In the present study, by assessing the effect of a specific p38 mitogen-activated protein kinase (MAPK) inhibitor, SB203580, on the sec...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2002.97.1.0112

    authors: Park MJ,Park IC,Hur JH,Kim MS,Lee HC,Woo SH,Lee KH,Rhee CH,Hong SI,Lee SH

    更新日期:2002-07-01 00:00:00

  • Buenos Aires experience with the Neuroform self-expanding stent for the treatment of intracranial aneurysms.

    abstract:OBJECT:The authors report their experience with the use of the Neuroform Microdelivery System for intravascular reconstruction. They assess the technical feasibility of the system, the efficacy of the combined application of stent and detachable coils, and the follow-up findings. METHODS:Fifty patients found to harbor...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2005.102.2.0235

    authors: Lylyk P,Ferrario A,Pasbón B,Miranda C,Doroszuk G

    更新日期:2005-02-01 00:00:00

  • Limitations of the transcallosal transchoroidal approach to the third ventricle.

    abstract:OBJECT:The aim of this study was to determine the anatomical limitations of the transcallosal transchoroidal approach to the third ventricle. METHODS:Twenty-six formalin-fixed specimens were studied. Sagittal dissections were used to determine the anatomical relationships of the foramen of Monro, the angle of approach...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2008.7.JNS08124

    authors: Ulm AJ,Russo A,Albanese E,Tanriover N,Martins C,Mericle RM,Pincus D,Rhoton AL

    更新日期:2009-09-01 00:00:00

  • Bilateral trigeminal neuralgia.

    abstract::Bilateral trigeminal neuralgia occurred in 32 (11.9%) of 269 consecutive patients who were treated with radiofrequency electrocoagulation (RFE). This is a higher incidence than has been reported before and may be explained by the prospective nature of the present study, the long follow-up period, and the inclusion of ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1987.67.1.0044

    authors: Brisman R

    更新日期:1987-07-01 00:00:00

  • Neurosurgery and consciousness: historical sketch and future possibilities.

    abstract::Neurosurgery has played an important role in the development of neuroscience and the science of consciousness. In this paper, the authors reflect on some of the historical contributions of neurosurgeons to the science of consciousness and discuss the ways in which clinical neurosurgery can contribute to the science of...

    journal_title:Journal of neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.3171/2012.6.JNS112136

    authors: Hasegawa H,Jamieson GA,Ashkan K

    更新日期:2012-09-01 00:00:00

  • Effect of regional spinal cord blood flow and central control in recovery from spinal cord injury.

    abstract::Forty-two cats were subjected to decerebration, thoracic and lumbar laminectomies, and isolation of the sciatic nerves. Spinal evoked potentials in response to bilateral sciatic nerve stimulation were recorded at L-3, and the spinal cord blood flow (SCBF) was measured by the hydrogen clearance technique. Thoracic cord...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1989.71.5.0747

    authors: Chehrazi BB,Scremin O,Decima EE

    更新日期:1989-11-01 00:00:00

  • Cortical motor and somatosensory representation: effect of cerebral lesions.

    abstract:OBJECT:Changes in cortical representation in patients with cerebral lesions may alter the correlation between cortical anatomy and function. This is of potential clinical significance when the extent of cortical resection is based on surface anatomical landmarks. METHODS:Fifty-one patients with supratentorial lesions ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2000.92.2.0242

    authors: Bittar RG,Olivier A,Sadikot AF,Andermann F,Reutens DC

    更新日期:2000-02-01 00:00:00

  • Increased prevalence of autoimmune disease in patients with unilateral compared with bilateral moyamoya disease.

    abstract::OBJECT This study explored whether there were differences between the autoimmune disease prevalence rates in unilateral and bilateral moyamoya disease (MMD). METHODS The authors performed a retrospective review of data obtained from the medical records of their hospital, analyzing and comparing the clinical characteri...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2015.4.JNS142936

    authors: Chen JB,Liu Y,Zhou LX,Sun H,He M,You C

    更新日期:2016-05-01 00:00:00

  • The facial nerve in medial acoustic neuromas.

    abstract:OBJECT:Functional results after surgery for acoustic neuromas that have little or no growth within the internal auditory canal are controversial, because these medial tumors can grow to a considerable size within the cerebellopontine angle (CPA) before symptoms occur. METHODS:A prospective study was designed to evalua...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2002.97.5.1083

    authors: Strauss C

    更新日期:2002-11-01 00:00:00