Abstract
Background
In order to compare the morphometry of foramen magnum (FM) in a matched-pair study, in children with non-syndromic craniosynostosis with and without Chiari I malformation (CMI), both brain magnetic resonance (MRI) and multidetector computed tomography (MDCT) images were utilized.
Methods
Brain MR images were retrieved from the Helsinki University Hospital Picture Archiving and Communications System to identify patients with CMI during 1.1.2004 to 31.3.2009. Age-, gender-, and craniosynostosis-matched controls were retrieved from the same cohort. Morphometric analysis of FM was carried out.
Results
Seven patients with non-syndromic craniosynostosis with CMI were recorded. In CMI patients, the absolute anteroposterior length was 33.4 mm as compared to 36.7 mm in controls (p = 0.023). The mean width was 28.1 and 29.9 mm (p = 0.29), and the cross-sectional area was 654.1 and 764.9 mm2 (p = 0.11) in CMI and controls, respectively. In CMI patients, the relative anteroposterior length of the FM was, on average, 91 % of the control’s measurements. On average, the width was 95 % and the cross-sectional area was 88 % of the control’s results.
Conclusions
In pediatric non-syndromic craniosynostosis patients, a statistically significant reduced anteroposterior diameter of the FM is found in patients with an adjacent CMI as compared to their age-, gender-, and type-matched controls of craniosynostosis.
Similar content being viewed by others
References
Aydin S, Hanimoglu H, Tanriverdi T, Yentur E, Kaynar MY (2005) Chiari type I malformations in adults: a morphometric analysis of the posterior cranial fossa. Surg Neurol 64:237–241, discussion 241
Barkovich AJ, Wippold FJ, Sherman JL, Citrin CM (1986) Significance of cerebellar tonsillar position on MR. AJNR Am J Neuroradiol 7:795–799
Bland JM, Altman DG (1994) Matching. BMJ 309:1128
Caldarelli M, Novegno F, Vassimi L, Romani R, Tamburrini G, Di Rocco C (2007) The role of limited posterior fossa craniectomy in the surgical treatment of Chiari malformation Type I: experience with a pediatric series. J Neurosurg 106:187–195
Cinalli G, Spennato P, Sainte-Rose C, Arnaud E, Aliberti F, Brunelle F, Cianciulli E, Renier D (2005) Chiari malformation in craniosynostosis. Childs Nerv Syst 21:889–901
Dagtekin A, Avci E, Kara E, Uzmansel D, Dagtekin O, Koseoglu A, Talas D, Bagdatoglu C (2011) Posterior cranial fossa morphometry in symptomatic adult Chiari I malformation patients: comparative clinical and anatomical study. Clin Neurol Neurosurg 113:399–403
Dufton JA, Habeeb SY, Heran MK, Mikulis DJ, Islam O (2011) Posterior fossa measurements in patients with and without Chiari I malformation. Can J Neurol Sci 38:452–455
Furtado SV, Thakre DJ, Venkatesh PK, Reddy K, Hegde AS (2010) Morphometric analysis of foramen magnum dimensions and intracranial volume in pediatric Chiari I malformation. Acta Neurochir (Wien) 152:221–227, discussion 227
Gehweiler JA Jr, Daffner RH, Roberts L Jr (1983) Malformations of the atlas vertebra simulating the Jefferson fracture. AJR Am J Roentgenol 140:1083–1086
Gladstone JP, Dodick DW (2004) Revised 2004 International Classification of Headache Disorders: new headache types. Can J Neurol Sci 31:304–314
Hecht JT, Nelson FW, Butler IJ, Horton WA, Scott CI Jr, Wassman ER, Mehringer CM, Rimoin DL, Pauli RM (1985) Computerized tomography of the foramen magnum: achondroplastic values compared to normal standards. Am J Med Genet 20:355–360
Leikola J, Koljonen V, Valanne L, Hukki J (2009) The incidence of Chiari malformation in nonsyndromic, single suture craniosynostosis. Childs Nerv Syst
Mikulis DJ, Diaz O, Egglin TK, Sanchez R (1992) Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology 183:725–728
Noudel R, Jovenin N, Eap C, Scherpereel B, Pierot L, Rousseaux P (2009) Incidence of basioccipital hypoplasia in Chiari malformation type I: comparative morphometric study of the posterior cranial fossa. Clinical article. J Neurosurg 111:1046–1052
Novegno F, Caldarelli M, Massa A, Chieffo D, Massimi L, Pettorini B, Tamburrini G, Di Rocco C (2008) The natural history of the Chiari Type I anomaly. J Neurosurg Pediatr 2:179–187
Sgouros S, Kountouri M, Natarajan K (2006) Posterior fossa volume in children with Chiari malformation Type I. J Neurosurg 105:101–106
Sgouros S, Kountouri M, Natarajan K (2007) Skull base growth in children with Chiari malformation Type I. J Neurosurg 107:188–192
Tubbs RS, Bailey M, Barrow WC, Loukas M, Shoja MM, Oakes WJ (2009) Morphometric analysis of the craniocervical juncture in children with Chiari I malformation and concomitant syringobulbia. Childs Nerv Syst 25:689–692
Tubbs RS, Lancaster JR, Mortazavi MM, Shoja MM, Chern JJ, Loukas M, Cohen-Gadol AA (2011) Morphometry of the outlet of the foramen magnum in crania with atlantooccipital fusion. J Neurosurg Spine 15:55–59
Van den Broek MJ, Arbues AS, Chalard F, Pinto Da Costa NM, Trang H, Dorfmuller G, Evrard PP, Husson I, Servais LJ (2009) Chiari type I malformation causing central apnoeas in a 4-month-old boy. Eur J Paediatr Neurol 13:463–465
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Leikola, J., Haapamäki, V., Karppinen, A. et al. Morphometric comparison of foramen magnum in non-syndromic craniosynostosis patients with or without Chiari I malformation. Acta Neurochir 154, 1809–1813 (2012). https://doi.org/10.1007/s00701-012-1451-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-012-1451-9