Complex Chiari Malformation: What the Neurosurgeon Needs to Know
Chiari malformation type 1 is a frequently encountered but incompletely understood morphologic variant that may present with headache and lower cranial nerve symptoms. The main surgical treatment for Chiari malformation type 1 is suboccipital decompression. Further research has identified
a subset of patients with Chiari malformation type 1 with radiographic findings that predispose to suboptimal outcomes from suboccipital decompression alone. This disease process has come to be referred to as complex Chiari malformation. Here, we discuss imaging findings of complex Chiari
malformation, identify craniovertebral metrics used to stratify patients, and propose a reporting structure to assist our neurosurgical colleagues in the selection of appropriate treatment.
Learning Objective: To understand imaging findings and radiographic metrics associated with Complex Chiari malformation and their implication on surgical management
Learning Objective: To understand imaging findings and radiographic metrics associated with Complex Chiari malformation and their implication on surgical management
Keywords: AAI = atlantoaxial instability; ADI = atlantodental interval; BAI = basion-axis interval; BI = basilar invagination; CCI = craniocervical instability; CCM = complex Chiari malformation; CDP = clivodental pivot; CM1 = Chiari malformation type 1; CVJ = craniovertebral junction; CXA = clivo-axial angle; OCF = occipitocervical fusion; SOD = suboccipital decompression; VBSC = ventral brainstem compression; VCMD = ventral cervicomedullary dura; pB-C2 = perpendicular basion-C2 line (Grabb line)
Document Type: Research Article
Publication date: January 1, 2022
- Access Key
- Free content
- Partial Free content
- New content
- Open access content
- Partial Open access content
- Subscribed content
- Partial Subscribed content
- Free trial content