Tag Archives: Cerebellum

Chiari malformation and the posterior fossa

SyringomyeliaChiari Malformation type 1 (CM-I) is an anatomical hindbrain abnormality having various symptoms (headache, pain in the neck and shoulders) because of obstruction of cerebrospinal fluid circulation and compression of hindbrain tissues such as the cerebellum, brain stem and spinal nerve. Most CM-I have syringomyelia. There is no direct test for CM-I and often symptoms are misinterpreted. Indicating tests are MRI, CT, neurological tests and CINE PC MRI. Treatment is a surgical operation called “posterior fossa compression”. Recently, researchers from the Netherlands and Turkey conducted different studies to examine this disorder. Akar et al. tested the usefulness of fractal analysis to examine the morphological complexity features of CM-I. Fractal Dimension (FD) analysis conducts the structural differences between patients with MCI (n=17) and healthy control subjects (n=16). Results showed that patients with CMI have larger cerebellar gray matter (GM) areas compared to controls, in contrast to other studies. FD could be a significant indicator for brain abnormalities in the cerebellum of CMI. It seems to be the case that the higher the FD value of cerebellar , the more complex object structure was. Rijken et al. found by examining 28 not operated, 85 operated craniosynostosis patients and 34 control that development of CMI is more likely to be supra tentorial. Craniosynostosis patients with CMI have similar cerebellar volume (CV) and posterior fossa volume (PFV) to control subjects, but they do have a significantly higher CV/PFV ratio. A higher CV/PFV ratio can be regarded as a predisposing factor for the development of CMI. In the end Rijken et al. advise to focus more on the skull vault itself.

Johannes Freiherr von Boeselager

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