{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:47:28Z","timestamp":1777420048528,"version":"3.51.4"},"reference-count":9,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Brain herniation is one of the most feared complications of many neurological pathologies. However, current understanding of the mechanisms behind brain herniation syndromes is poor. By investigating the correlations between raised intracranial pressure (ICP) and herniation of the cerebellar tonsils, we hope to develop a model that can be used to study intracranial fluid dynamics and its effects on brain tissue. This will facilitate evaluation of patients with elevated ICP and development of novel treatments including surgical approaches for decompressing the posterior cranial fossa and upper cervical spine. A standard suboccipital surgical approach was used to expose the foramen magnum and observe movements of the cerebellar tonsils in fresh cadavers. A urinary Foley catheter balloon in the parietal extradural space was used to simulate a mass effect while ICP was monitored. The baseline anatomy differed widely among the cadaver specimens. However, and overall, we found that as ICP rises, the cerebellar tonsils descend through the foramen magnum at a rate of 0.3\u2009mm per 1\u2009mmHg increase in ICP. A mean descent of 6.2\u2009mm was observed for a mean ICP increase of 17\u2009mmHg. In this cadaveric study, we present a method and model for exploring brain herniation syndromes in the context of ICP changes. This could allow for further models to study the effects of other neuropathologies on the cerebellar tonsils, including posterior cranial fossa mass lesions and cerebellar hemorrhage.<\/jats:p>","DOI":"10.1002\/ca.23827","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T02:05:14Z","timestamp":1639620314000},"page":"251-255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An anatomical model for studying cerebellar tonsillar herniation related to raised intracranial pressure"],"prefix":"10.1002","volume":"35","author":[{"given":"Kennedy","family":"Carpenter","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and Ochsner Neuroscience Institute Ochsner Health System  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8502-7952","authenticated-orcid":false,"given":"Joe","family":"Iwanaga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aimee","family":"Aysenne","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron S.","family":"Dumont","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. J.","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Ochsner Neuroscience Institute Ochsner Health System  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-1047","authenticated-orcid":false,"given":"R. Shane","family":"Tubbs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Ochsner Neuroscience Institute Ochsner Health System  New Orleans Louisiana USA"},{"name":"Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Anatomical Sciences St. George's University  St. George's Grenada"},{"name":"Department of Structural &amp; Cellular Biology Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Surgery Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00596501"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23671"},{"key":"e_1_2_8_4_1","unstructured":"Knight J. &De Jesus O.(2021).Tonsillar herniation. [Updated 2021 Feb 7]. In: StatPearls [internet]. Treasure Island (FL): StatPearls Publishing.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562170\/"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.56.12.1746"},{"key":"e_1_2_8_6_1","unstructured":"Munakomi S &Das J. (2021).Brain herniation. [Updated 2021 Feb 8]. In: StatPearls [internet]. Treasure Island (FL): StatPearls Publishing;2021.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542246\/"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1997.86.3.0572"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200007000-00050"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-015-0168-z"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200301000-00028"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23827","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ca.23827","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23827","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T05:25:09Z","timestamp":1692249909000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.23827"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,20]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1002\/ca.23827"],"URL":"https:\/\/doi.org\/10.1002\/ca.23827","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"value":"0897-3806","type":"print"},{"value":"1098-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,20]]},"assertion":[{"value":"2021-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}