{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:04:18Z","timestamp":1792029858481,"version":"4.4.0"},"reference-count":38,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"am","delay-in-days":355,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Neurologic Clinics"],"published-print":{"date-parts":[[2022,5]]},"DOI":"10.1016\/j.ncl.2021.11.007","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T09:31:59Z","timestamp":1648719119000},"page":"297-307","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":24,"title":["Chiari Malformation (Update on Diagnosis and Treatment)"],"prefix":"10.1016","volume":"40","author":[{"given":"Jared S.","family":"Rosenblum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. Jonathan","family":"Pomeraniec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Heiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"CN_Suppl_1","key":"10.1016\/j.ncl.2021.11.007_bib1","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1093\/neuros\/nyx377","article-title":"Pathogenesis of Chiari I-Pathophysiology of syringomyelia: implications for therapy: a summary of 3 decades of clinical research","volume":"64","author":"Oldfield","year":"2017","journal-title":"Neurosurgery"},{"issue":"11","key":"10.1016\/j.ncl.2021.11.007_bib2","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.3174\/ajnr.A6743","article-title":"The perplexity surrounding chiari malformations\u2014are we any wiser now?","volume":"41","author":"Hiremath","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.1016\/j.ncl.2021.11.007_bib3","first-page":"823","article-title":"Chiari's description of cerebellar ectopy (1891): With a summary of Cleland's and Arnold's contributions and some early observations on neural-tube defects","volume":"75","author":"Koehler","year":"1991","journal-title":"J\u00a0Neurosurg"},{"key":"10.1016\/j.ncl.2021.11.007_bib4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000120293","article-title":"Concerning alterations in the cerebellum resulting from cerebral hydrocephalus","volume":"13","author":"Chiari","year":"1891","journal-title":"Pediatr Neurosci"},{"key":"10.1016\/j.ncl.2021.11.007_bib5","first-page":"71","article-title":"Uber Veranderungen des Kleinhirns, des Pons und der Medulla Oblongata infolge von kongenitaler Hy- drocephalie des Grosshirns.","volume":"63","author":"Chiari","year":"1896","journal-title":"Denkschr der Kais Akad Wiss Wien math-naturw"},{"key":"10.1016\/j.ncl.2021.11.007_bib6","first-page":"1","article-title":"Myelocyste, transposition von Gewebskeimen und Sympodie","volume":"16","author":"Arnold","year":"1894","journal-title":"Zieglers Beitr Pathol Anal"},{"key":"10.1016\/j.ncl.2021.11.007_bib7","first-page":"257","article-title":"Contribution to the study of spina bifida, encephalocele, and anencephalus","volume":"17","author":"Cleland","year":"1883","journal-title":"J\u00a0Anat Physiol"},{"issue":"3","key":"10.1016\/j.ncl.2021.11.007_bib8","first-page":"127","article-title":"Development of so-called dysraphism; with embryologic evidence of clinical Arnold-Chiari and Dandy-Walker malformations","volume":"130","author":"Padget","year":"1972","journal-title":"Johns Hopkins Med J"},{"issue":"2","key":"10.1016\/j.ncl.2021.11.007_bib9","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1017\/S0317167100031632","article-title":"Cephalic axial skeletal-neural dysraphic disorders: embryology and pathology","volume":"18","author":"Mar\u00edn-Padilla","year":"1991","journal-title":"Can J Neurol Sci"},{"issue":"4","key":"10.1016\/j.ncl.2021.11.007_bib10","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.nec.2015.06.003","article-title":"Pathogenesis and Cerebrospinal Fluid Hydrodynamics of the Chiari I Malformation","volume":"26","author":"Buell","year":"2015","journal-title":"Neurosurg Clin N Am"},{"issue":"4","key":"10.1016\/j.ncl.2021.11.007_bib11","first-page":"553","article-title":"Elucidating the pathophysiology of syringomyelia","volume":"91","author":"Heiss","year":"1999","journal-title":"J\u00a0Neurosurg"},{"key":"10.1016\/j.ncl.2021.11.007_bib12","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1093\/neurosurgery\/6.CN_suppl_1.131","article-title":"The mechanism of syringomyelia and its surgical correction","volume":"6","author":"Gardner","year":"1958","journal-title":"Clin Neurosurg"},{"key":"10.1016\/j.ncl.2021.11.007_bib13","series-title":"Handbook of clinical neurology","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/B978-0-444-64189-2.00002-0","article-title":"Chapter 2: Chiari I deformity in children: etiopathogenesis and radiologic diagnosis","volume":"Vol 155","author":"Raybaud","year":"2018"},{"key":"10.1016\/j.ncl.2021.11.007_bib14","first-page":"40","article-title":"Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa","volume":"86","author":"Nishikawa","year":"1997","journal-title":"J\u00a0Neurosurg"},{"issue":"6","key":"10.1016\/j.ncl.2021.11.007_bib15","first-page":"1","article-title":"Two distinct populations of Chiari I malformation based on presence or absence of posterior fossa crowdedness on magnetic resonance imaging","volume":"126","author":"Taylor","year":"2016","journal-title":"J\u00a0Neurosurg"},{"key":"10.1016\/j.ncl.2021.11.007_bib16","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/B978-0-444-64189-2.00002-0","article-title":"Chiari I deformity in children: etiopathogenesis and radiologic diagnosis","volume":"155","author":"Raybaud","year":"2018","journal-title":"Handb Clin Neurol"},{"issue":"11","key":"10.1016\/j.ncl.2021.11.007_bib17","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1002\/jbmr.3531","article-title":"Chiari I malformation and basilar invagination in fibrous dysplasia: prevalence, mechanisms, and clinical implications","volume":"33","author":"Pan","year":"2018","journal-title":"J\u00a0Bone Miner Res"},{"key":"10.1016\/j.ncl.2021.11.007_bib18","doi-asserted-by":"crossref","unstructured":"Urbizu A, Khan TN, Ashley-Koch AE. Genetic dissection of Chiari malformation type I using endophenotypes and stratification. J. Rare Dis. Res. Treat, 2 (2), 2017, 35-42 Available at: www.rarediseasesjournal.com. December 23, 2021","DOI":"10.29245\/2572-9411\/2017\/2.1082"},{"issue":"3","key":"10.1016\/j.ncl.2021.11.007_bib19","doi-asserted-by":"crossref","first-page":"e414","DOI":"10.1212\/NXG.0000000000000414","article-title":"Neuraxial Dysraphism in EPAS1-Associated Syndrome due to Improper Mesenchymal Transition","volume":"6","author":"Rosenblum","year":"2020","journal-title":"Neurol Genet"},{"key":"10.1016\/j.ncl.2021.11.007_bib20","author":"Kniffin"},{"key":"10.1016\/j.ncl.2021.11.007_bib21","series-title":"The Chiari malformations","first-page":"443","article-title":"Chapter 38: treatment of the adult Chiari I Malformation","author":"Mastorakos","year":"2020"},{"key":"10.1016\/j.ncl.2021.11.007_bib22","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1093\/brain\/61.4.415","article-title":"A\u00a0deformity of the hindbrain associated with internal hydrocephalus. Its relation to the Arnold-Chiari malformation","volume":"61","author":"McConnell","year":"1938","journal-title":"Brain"},{"key":"10.1016\/j.ncl.2021.11.007_bib23","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1056\/NEJM194107242250401","article-title":"The Arnold- Chiari malformation. Diagnosis, demonstration by intraspinal Lipiodol and successful surgical treatment","volume":"225","author":"Adams","year":"1941","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ncl.2021.11.007_bib24","first-page":"245","article-title":"Arnold-Chiari deformity in an adult without obvious cause","volume":"2","author":"Bucy","year":"1945","journal-title":"J\u00a0Neurosurg"},{"issue":"3","key":"10.1016\/j.ncl.2021.11.007_bib25","first-page":"199","article-title":"The surgical treatment of Arnold-Chiari malformation in adults; an explanation of its mechanism and importance of encephalography in diagnosis","volume":"7","author":"Gardner","year":"1950","journal-title":"J\u00a0Neurosurg"},{"issue":"4","key":"10.1016\/j.ncl.2021.11.007_bib26","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1227\/00006123-198304000-00003","article-title":"Chiari malformation presenting in adults: a surgical experience in 127 cases","volume":"12","author":"Levy","year":"1983","journal-title":"Neurosurgery"},{"issue":"5","key":"10.1016\/j.ncl.2021.11.007_bib27","first-page":"835","article-title":"Thecoperitoneal shunting for syringomy- elia","volume":"75","author":"Pillay","year":"1991","journal-title":"J\u00a0Neurosurg"},{"issue":"4","key":"10.1016\/j.ncl.2021.11.007_bib28","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s10143-009-0214-4","article-title":"Dura splitting decompression in Chiari type 1 malformation: clinical experience and radiological findings","volume":"32","author":"Chauvet","year":"2009","journal-title":"Neurosurg Rev"},{"issue":"1","key":"10.1016\/j.ncl.2021.11.007_bib29","doi-asserted-by":"crossref","first-page":"42","DOI":"10.3171\/PED\/2008\/2\/7\/042","article-title":"Comparison of posterior fossa decompression with and without duraplasty for the surgical treatment of Chiari malformation Type I in pediatric patients: a meta-analysis","volume":"2","author":"Durham","year":"2008","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"5","key":"10.1016\/j.ncl.2021.11.007_bib30","first-page":"844","article-title":"Foramen magnum decompression with removal of the outer layer of the dura as treatment for syringomyelia occurring with Chiari I malformation","volume":"33","author":"Isu","year":"1993","journal-title":"Neurosurgery"},{"key":"10.1016\/j.ncl.2021.11.007_bib31","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1743-8454-6-7","article-title":"Delamination technique together with longitudinal incisions for treatment of Chiari I\/syringomyelia complex: a prospective clinical study","volume":"6","author":"Kotil","year":"2009","journal-title":"Cerebrospinal Fluid Res"},{"issue":"4","key":"10.1016\/j.ncl.2021.11.007_bib32","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1590\/S0004-282X2010000400027","article-title":"Suboccipital craniectomy with or without duraplasty: what is the best choice in patients with Chiari type 1 malformation?","volume":"68","author":"Romero","year":"2010","journal-title":"Arq Neuropsiquiatr"},{"issue":"6","key":"10.1016\/j.ncl.2021.11.007_bib33","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1093\/neuros\/nyy475","article-title":"Chiari I Malformation Common Data Element Working Group. Development of Common Data Elements for Use in Chiari Malformation Type I Clinical Research: An NIH\/NINDS Project","volume":"85","author":"Luciano","year":"2019","journal-title":"Neurosurgery"},{"issue":"2","key":"10.1016\/j.ncl.2021.11.007_bib34","first-page":"232","article-title":"Surgical treatment of Chiari malformation with and without syringomyelia: experience with 177 adult patients","volume":"118","author":"Batzdorf","year":"2013","journal-title":"J\u00a0Neurosurg"},{"key":"10.1016\/j.ncl.2021.11.007_bib35","first-page":"1","article-title":"Extradural decompression versus duraplasty in Chiari malformation type I with syrinx: outcomes on scoliosis from the Park-Reeves Syringomyelia Research Consortium","author":"Sadler","year":"2021","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.ncl.2021.11.007_bib36","first-page":"1","article-title":"Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study","author":"Yahanda","year":"2021","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"2","key":"10.1016\/j.ncl.2021.11.007_bib37","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1093\/neuros\/nyaa460","article-title":"Occipital-cervical fusion and ventral decompression in the surgical management of Chiari-1 Malformation and Syringomyelia: analysis of data from the Park-Reeves Syringomyelia Research Consortium","volume":"88","author":"CreveCoeur","year":"2021","journal-title":"Neurosurgery"},{"key":"10.1016\/j.ncl.2021.11.007_bib38","first-page":"1","article-title":"Factors associated with syrinx size in pediatric patients treated for Chiari malformation type I and syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium","author":"Hale","year":"2020","journal-title":"J\u00a0Neurosurg Pediatr"}],"container-title":["Neurologic Clinics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0733861921001183?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0733861921001183?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T10:21:58Z","timestamp":1760005318000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0733861921001183"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["S0733861921001183"],"URL":"https:\/\/doi.org\/10.1016\/j.ncl.2021.11.007","relation":{},"ISSN":["0733-8619"],"issn-type":[{"value":"0733-8619","type":"print"}],"subject":[],"published":{"date-parts":[[2022,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Chiari Malformation (Update on Diagnosis and Treatment)","name":"articletitle","label":"Article Title"},{"value":"Neurologic Clinics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ncl.2021.11.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}