{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:15:59Z","timestamp":1791576959587,"version":"4.3.4"},"reference-count":54,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["World Neurosurgery"],"published-print":{"date-parts":[[2020,4]]},"DOI":"10.1016\/j.wneu.2020.01.147","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T13:18:29Z","timestamp":1584623909000},"page":"444-453","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":26,"special_numbering":"C","title":["Ventrolateral Tonsillar Position Defines Novel Chiari 0.5 Classification"],"prefix":"10.1016","volume":"136","author":[{"given":"Peter F.","family":"Morgenstern","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Tosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Uribe-Cardenas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Greenfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.wneu.2020.01.147_bib1","first-page":"45","article-title":"Developments in the treatment of Chiari type 1 malformations over the past decade","volume":"4","author":"Passias","year":"2018","journal-title":"J\u00a0Spine Surg"},{"key":"10.1016\/j.wneu.2020.01.147_bib2","doi-asserted-by":"crossref","first-page":"554","DOI":"10.3171\/2010.3.PEDS09489","article-title":"Chiari malformation type I in children younger than age 6 years: presentation and surgical outcome","volume":"5","author":"Albert","year":"2010","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib3","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0387-7604(01)00383-7","article-title":"Sleep apnea syndrome associated with a type I Chiari malformation","volume":"24","author":"Yoshimi","year":"2002","journal-title":"Brain Dev"},{"key":"10.1016\/j.wneu.2020.01.147_bib4","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1111\/ped.12639","article-title":"Type I Chiari malformation presenting with laryngomalacia and dysphagia","volume":"57","author":"Liu","year":"2015","journal-title":"Pediatr Int"},{"key":"10.1016\/j.wneu.2020.01.147_bib5","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/S0165-5876(00)00439-0","article-title":"Respiratory obstruction as a sign of brainstem dysfunction in infants with Chiari malformations","volume":"57","author":"Portier","year":"2001","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"10.1016\/j.wneu.2020.01.147_bib6","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1097\/MOP.0000000000000679","article-title":"Headache, Chiari I malformation and foramen magnum decompression","volume":"30","author":"Olszewski","year":"2018","journal-title":"Curr Opin Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib7","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1055\/s-0036-1584563","article-title":"Chiari type 1 deformity in children: pathogenetic, clinical, neuroimaging, and management aspects","volume":"47","author":"Poretti","year":"2016","journal-title":"Neuropediatrics"},{"issue":"Suppl 1","key":"10.1016\/j.wneu.2020.01.147_bib8","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s10072-017-2950-5","article-title":"Chiari malformation-related headache: outcome after surgical treatment","volume":"38","author":"Beretta","year":"2017","journal-title":"Neurol Sci"},{"key":"10.1016\/j.wneu.2020.01.147_bib9","doi-asserted-by":"crossref","first-page":"161","DOI":"10.3171\/2014.10.PEDS14295","article-title":"Pediatric and adult Chiari malformation type I surgical series 1965-2013: a review of demographics, operative treatment, and outcomes","volume":"15","author":"Arnautovic","year":"2015","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib10","doi-asserted-by":"crossref","first-page":"343","DOI":"10.3171\/2015.7.PEDS1594","article-title":"Natural and surgical history of Chiari malformation type I in the pediatric population","volume":"17","author":"Pomeraniec","year":"2016","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib11","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00381-011-1616-5","article-title":"A\u00a0new form of herniation: the Chiari V malformation","volume":"28","author":"Tubbs","year":"2012","journal-title":"Childs Nerv Syst"},{"key":"10.1016\/j.wneu.2020.01.147_bib12","doi-asserted-by":"crossref","first-page":"368","DOI":"10.3171\/2014.1.PEDS13105","article-title":"Relationship of syrinx size and tonsillar descent to spinal deformity in Chiari malformation type I with associated syringomyelia","volume":"13","author":"Godzik","year":"2014","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib13","doi-asserted-by":"crossref","first-page":"E23","DOI":"10.1097\/00007632-200201150-00011","article-title":"Adult scoliosis in syringomyelia associated with Chiari I malformation","volume":"27","author":"Ono","year":"2002","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.wneu.2020.01.147_bib14","doi-asserted-by":"crossref","first-page":"498","DOI":"10.3171\/2018.10.PEDS18407","article-title":"Patients with \u201cbenign\u201d Chiari I malformations require surgical decompression at a low rate","volume":"23","author":"Leon","year":"2019","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib15","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2214\/ajr.150.1.163","article-title":"MR imaging of Chiari II malformation","volume":"150","author":"el Gammal","year":"1988","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.wneu.2020.01.147_bib16","doi-asserted-by":"crossref","first-page":"587","DOI":"10.3171\/2018.1.PEDS17496","article-title":"Predictors of mortality in children with myelomeningocele and symptomatic Chiari type II malformation","volume":"21","author":"McDowell","year":"2018","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib17","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1111\/j.1442-200X.2012.03660.x","article-title":"Sleep-disordered breathing in children with Chiari malformation type II and myelomeningocele","volume":"54","author":"Alsaadi","year":"2012","journal-title":"Pediatr Int"},{"key":"10.1016\/j.wneu.2020.01.147_bib18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/2011.4.PEDS10528","article-title":"Pediatric Chiari malformation type 0: a 12-year institutional experience","volume":"8","author":"Chern","year":"2011","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib19","doi-asserted-by":"crossref","first-page":"246","DOI":"10.2176\/nmc.30.246","article-title":"Magnetic resonance imaging of Chiari malformations","volume":"30","author":"Yamanaka","year":"1990","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.1016\/j.wneu.2020.01.147_bib20","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1002\/ca.23051","article-title":"The newer classifications of the Chiari malformations with clarifications: an anatomical review","volume":"31","author":"Azahraa Haddad","year":"2018","journal-title":"Clin Anat"},{"key":"10.1016\/j.wneu.2020.01.147_bib21","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.clineuro.2017.03.024","article-title":"No significant difference between chiari malformation type 1.5 and type I","volume":"157","author":"Liu","year":"2017","journal-title":"Clin Neurol Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.147_bib22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0899-7071(02)00498-9","article-title":"Chiari III malformation: varieties of MRI appearances in two patients","volume":"27","author":"Cakirer","year":"2003","journal-title":"Clin Imaging"},{"key":"10.1016\/j.wneu.2020.01.147_bib23","first-page":"107","article-title":"Chiari III malformation: imaging features","volume":"13","author":"Castillo","year":"1992","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.1016\/j.wneu.2020.01.147_bib24","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1007\/s00381-016-3255-3","article-title":"The Chiari 3.5 malformation: a review of the only reported case","volume":"32","author":"Fisahn","year":"2016","journal-title":"Child Nerv Syst"},{"key":"10.1016\/j.wneu.2020.01.147_bib25","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1053\/crad.2001.0960","article-title":"Chiari III malformation: antenatal MRI diagnosis","volume":"57","author":"Lee","year":"2002","journal-title":"Clin Radiol"},{"key":"10.1016\/j.wneu.2020.01.147_bib26","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1159\/000187127","article-title":"Unique defect representing features of Chiari type III and IV malformations","volume":"44","author":"Chaudhari","year":"2008","journal-title":"Pediatr Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.147_bib27","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jocn.2018.06.045","article-title":"Chiari malformation clusters describe differing presence of concurrent anomalies based on Chiari type","volume":"58","author":"Horn","year":"2018","journal-title":"J\u00a0Clin Neurosci"},{"key":"10.1016\/j.wneu.2020.01.147_bib28","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3171\/2011.5.PEDS1121","article-title":"Chiari malformation type I and syrinx in children undergoing magnetic resonance imaging","volume":"8","author":"Strahle","year":"2011","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib29","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.pediatrneurol.2009.01.003","article-title":"Chiari type I malformation in a pediatric population","volume":"40","author":"Aitken","year":"2009","journal-title":"Pediatr Neurol"},{"key":"10.1016\/j.wneu.2020.01.147_bib30","doi-asserted-by":"crossref","first-page":"150","DOI":"10.3171\/2014.12.PEDS14487","article-title":"Outcomes after suboccipital decompression without dural opening in children with Chiari malformation type I","volume":"16","author":"Kennedy","year":"2015","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib31","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3171\/2010.12.PEDS10379","article-title":"Institutional experience with 500 cases of surgically treated pediatric Chiari malformation Type I","volume":"7","author":"Tubbs","year":"2011","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib32","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":"3 Suppl","key":"10.1016\/j.wneu.2020.01.147_bib33","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3171\/ped.2007.106.3.187","article-title":"The role of limited posterior fossa craniectomy in the surgical treatment of Chiari malformation type I: experience with a pediatric series","volume":"106","author":"Caldarelli","year":"2007","journal-title":"J\u00a0Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.147_bib34","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s00381-007-0297-6","article-title":"Relevance of surgical strategies for the management of pediatric Chiari type I malformation","volume":"23","author":"Galarza","year":"2007","journal-title":"Child Nerv Syst"},{"key":"10.1016\/j.wneu.2020.01.147_bib35","first-page":"291","article-title":"Surgical experience in 130 pediatric patients with Chiari I malformations","volume":"99","author":"Tubbs","year":"2003","journal-title":"J\u00a0Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.147_bib36","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1007\/s00381-014-2424-5","article-title":"Comparison of posterior fossa decompression with or without duraplasty in children with Type I Chiari malformation","volume":"30","author":"Lee","year":"2014","journal-title":"Child Nerv Syst"},{"issue":"Suppl 3","key":"10.1016\/j.wneu.2020.01.147_bib37","doi-asserted-by":"crossref","first-page":"S275","DOI":"10.1007\/s10072-011-0684-3","article-title":"Natural history of Chiari type I malformation in children","volume":"32","author":"Massimi","year":"2011","journal-title":"Neurol Sci"},{"key":"10.1016\/j.wneu.2020.01.147_bib38","doi-asserted-by":"crossref","first-page":"214","DOI":"10.3171\/2011.5.PEDS1122","article-title":"Natural history of Chiari malformation type I following decision for conservative treatment","volume":"8","author":"Strahle","year":"2011","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib39","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3171\/PED\/2008\/2\/9\/179","article-title":"The natural history of the Chiari type I anomaly","volume":"2","author":"Novegno","year":"2008","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib40","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1212\/01.wnl.0000191394.53786.62","article-title":"Sleep-disordered breathing in patients with Chiari malformation: improvement after surgery","volume":"66","author":"Gagnadoux","year":"2006","journal-title":"Neurology"},{"key":"10.1016\/j.wneu.2020.01.147_bib41","doi-asserted-by":"crossref","first-page":"296","DOI":"10.3171\/2012.11.PEDS12297","article-title":"Central sleep apnea and associated Chiari malformation in children with syndromic craniosynostosis: treatment and outcome data from a supraregional national craniofacial center","volume":"11","author":"Addo","year":"2013","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib42","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1016\/j.clineuro.2013.05.025","article-title":"The role of nocturnal polysomnography in assessing children with Chiari type I malformation","volume":"115","author":"Dhamija","year":"2013","journal-title":"Clin Neurol Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.147_bib43","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.wneu.2017.04.082","article-title":"Chiari malformation type 1: a systematic review of natural history and conservative management","volume":"104","author":"Langridge","year":"2017","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.147_bib44","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/ca.22468","article-title":"Occipital neuralgia: anatomic considerations","volume":"28","author":"Cesmebasi","year":"2015","journal-title":"Clin Anat"},{"key":"10.1016\/j.wneu.2020.01.147_bib45","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/978-3-319-09066-5_2","article-title":"Occipital nerve stimulation","volume":"42","author":"Mammis","year":"2015","journal-title":"Adv Tech Stand Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.147_bib46","first-page":"e1891","article-title":"Occipital neuralgia in Chiari I malformation: two different events or two different faces of the same event?","volume":"9","author":"Tondo","year":"2017","journal-title":"Cureus"},{"key":"10.1016\/j.wneu.2020.01.147_bib47","doi-asserted-by":"crossref","first-page":"250","DOI":"10.3171\/PED.2008.2.10.250","article-title":"Incomplete lateral medullary syndrome in a patient with Chiari malformation type I presenting with combined trigeminal and vagal nerve dysfunction","volume":"2","author":"Dahdaleh","year":"2008","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"Suppl 1","key":"10.1016\/j.wneu.2020.01.147_bib48","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s10072-017-2915-8","article-title":"Chiari malformation type 1-related headache: the importance of a multidisciplinary study","volume":"38","author":"Curone","year":"2017","journal-title":"Neurol Sci"},{"key":"10.1016\/j.wneu.2020.01.147_bib49","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/j.jocn.2012.01.025","article-title":"Evaluation of operative procedures for symptomatic outcome after decompression surgery for Chiari type I malformation","volume":"19","author":"Kalb","year":"2012","journal-title":"J\u00a0Clin Neurosci"},{"key":"10.1016\/j.wneu.2020.01.147_bib50","doi-asserted-by":"crossref","first-page":"e5945","DOI":"10.1097\/MD.0000000000005945","article-title":"Comparison of posterior fossa decompression with and without duraplasty for the surgical treatment of Chiari malformation type I in adult patients","volume":"96","author":"Chen","year":"2017","journal-title":"Medicine"},{"key":"10.1016\/j.wneu.2020.01.147_bib51","doi-asserted-by":"crossref","first-page":"525","DOI":"10.3171\/2015.10.PEDS15369","article-title":"Chiari malformation type I surgery in pediatric patients. Part 2: complications and the influence of comorbid disease in California, Florida, and New York","volume":"17","author":"Greenberg","year":"2016","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib52","doi-asserted-by":"crossref","first-page":"519","DOI":"10.3171\/2015.10.PEDS15370","article-title":"Chiari malformation type I surgery in pediatric patients. Part 1: validation of an ICD-9-CM code search algorithm","volume":"17","author":"Ladner","year":"2016","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.wneu.2020.01.147_bib53","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1159\/000072467","article-title":"Reoperation for chiari malformations","volume":"39","author":"Sacco","year":"2003","journal-title":"Pediatr Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.147_bib54","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1159\/000371659","article-title":"National trends, complications, and hospital charges in pediatric patients with Chiari malformation type I treated with posterior fossa decompression with and without duraplasty","volume":"50","author":"Shweikeh","year":"2015","journal-title":"Pediatr Neurosurg"}],"container-title":["World Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875020301650?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875020301650?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T08:45:30Z","timestamp":1761813930000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1878875020301650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4]]},"references-count":54,"alternative-id":["S1878875020301650"],"URL":"https:\/\/doi.org\/10.1016\/j.wneu.2020.01.147","relation":{},"ISSN":["1878-8750"],"issn-type":[{"value":"1878-8750","type":"print"}],"subject":[],"published":{"date-parts":[[2020,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Ventrolateral Tonsillar Position Defines Novel Chiari 0.5 Classification","name":"articletitle","label":"Article Title"},{"value":"World Neurosurgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.wneu.2020.01.147","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}