Monitoring of cerebrospinal fluid flow by intraoperative ultrasound in patients with Chiari I malformation

  title={Monitoring of cerebrospinal fluid flow by intraoperative ultrasound in patients with Chiari I malformation},
  author={Li-Gang Cui and Ling Jiang and Hua-bin Zhang and Bin Liu and Jin-rui Wang and Jian-wen Jia and Wen Chen},
  journal={Clinical Neurology and Neurosurgery},
Changes in cerebrospinal fluid flow assessed using intraoperative MRI during posterior fossa decompression for Chiari malformation.
The authors observed significant CSF flow changes when simply positioning the patient for surgery, which put into question intraoperative flow assessments that suggest adequate decompression by PFD, whether by iMRI or intraoperative ultrasound.
Controversies in Chiari I malformations
  • J. Baisden
  • Medicine
    Surgical neurology international
  • 2012
The recommended treatment for Chiari I malformations I consists of decompressive suboccipital craniectomy and duroplasty when abnormal cine-flow MRI is observed preoperatively and blockage of CSF flow persists intraoperatively despite bony decompression.
The efficacy of intraoperative ultrasonography⁃assisted microinvasive cisterna magna reconstruction for Chiari malformation typeIwith syringomyelia
Microinvasive cisterna magna reconstruction is a surgical procedure with mininal injury, quick recovery, stable effect, fewer complications, and high security and provides reliable data and is easy to perform.
Malformación de Chiari tipo I tratada con descompresión de la fosa posterior apoyada por ultrasonido intraoperatorio
Intraoperative ultrasound provided information on cerebrospinal fluid (CSF) circulation through the cranioespinal junction, which allowed the surgical team not to perform the dural opening and the patient had a satisfactory evolution.
Quantification of changes in brain morphology following posterior fossa decompression surgery in women treated for Chiari malformation type 1
PurposeWhile 84% of patients surgically treated for Chiari malformation type 1 (CM1) demonstrate improved quality of life after posterior fossa decompression surgery, there are many risks associated
3T Intraoperative MRI for Management of Pediatric CNS Neoplasms
Intraoperative MRI is safe and increases the likelihood of gross total resection, albeit with increased operating room time, and reduces the need for early reoperation or repeat sedation for postoperative scans in children with brain tumors.
Chiari I Malformation in the Adult
Treatment today consists of suboccipital decompression to reestablish optimal CSF flow from the fourth ventricle, recreate a subtonsillar cistern, and relieve brainstem compression to improve surgical management of Chiari malformation.
Intraoperative Ultrasound in Chiari Type I Malformation
This chapter describes the authors’ experience using intraoperative USG in patients with Chiari malformation type I as a method for selection of candidates for posterior fossa decompression with bone removal alone.
Surgical Management of Chiari Malformations: Preliminary Results of Surgery According to the Mechanisms of Ptosis of the Brain Stem and Cerebellum.
In the management of Chiari malformation, appropriate surgical methods that address ptosis of the hindbrain should be chosen and each surgical approach resulted in a good improvement of neurological symptoms.


Cerebrospinal fluid flow waveforms: analysis in patients with Chiari I malformation by means of gated phase-contrast MR imaging velocity measurements.
CSF flow waveform analysis helps demonstrate abnormalities in CSF flow at the foramen magnum and the benefits of decompressive surgery in patients with the Chiari I malformation.
Cerebrospinal fluid dynamics in Chiari malformation associated with syringomyelia.
The syringomyelia in patients with CMI may be due to the decreased circulation time and abnormal dynamics of the CSF in the upper cervical segment, and the decompression of the foramen magnum with dural plasty is an alternative.
Tailored Operative Technique for Chiari Type I Malformation Using Intraoperative Color Doppler Ultrasonography
Optimal cerebrospinal fluid flow through the foramen magnum in anesthetized, prone patients was found to have the following characteristics: a peak velocity of 3 to 5 cm/s, bidirectional movement, and a waveform exhibiting vascular and respiratory variations.
Assessment of CSF dynamics and venous flow in the superior sagittal sinus by MRI in idiopathic intracranial hypertension: a preliminary study
MRI phase-mapping was used to study the relative importance of the pathophysiological factors thought to play a role in the development of IIH, and suggested CSF hypersecretion in three patients, whereas increased transependymal passage of CSF could have been the cause of negative calculated CSF production rates.
Intraoperative ultrasonography as a guide to patient selection for duraplasty after suboccipital decompression in children with Chiari malformation Type I.
In the setting of moderate-to-severe tonsillar CM-I, intraoperative ultrasonography demonstrating decompression of the subarachnoid spaces ventral and dorsal to the tonsils may not effectively select patients in whom bone decompression alone is sufficient.
Persistent syringomyelia following pediatric Chiari I decompression: radiological and surgical findings.
No single radiological measurement was found to aid in the prediction of which patients would not respond to the first decompressive procedure, and no operative finding was extraordinarily unique to any single patient.
Favorable results with syringosubarachnoid shunts for treatment of syringomyelia.
The syringosubarachnoid shunt is an effective therapeutic modality for many patients with syringomyelia, particularly if there is little or no tonsillar herniation.