{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T22:28:12Z","timestamp":1759530492548,"version":"3.37.3"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and Study Aims\u2003Chiari malformation type 1 (CM1) is one of the most discussed neurosurgical disorders. No consensus exists how to manage adult CM1 patients. We aimed to evaluate all adult CM1 patients consecutively managed at our institutions and discuss our approach based on the phase-contrast (PC) magnetic resonance imaging (MRI).<\/jats:p><jats:p>\n          Patients and Methods\u2003The medical charts of adult patients diagnosed with CM1 at two referral neurosurgical centers between 2010 and 2017 were reviewed. The patients were either managed conservatively or surgically. We evaluated the patients clinically with the Chicago Chiari Outcome Scale (CCOS). The radiologic diagnosis was based on both craniocervical and PC-MRI.<\/jats:p><jats:p>\n          Results\u2003Ninety adult CM1 patients were managed conservatively. Conservative treatment failed in 5 of these 90 patients. Seventy-two patients (including those 5 patients who did not benefit from conservative treatment) underwent posterior fossa decompression with duraplasty. Eighty-five patients (94.4%) from the conservative group and 61 patients (84.7%) from the surgical group were treated successfully. An aqueductal stroke volume (ASV) value of 12 \u00b5L was found as the cutoff value for surgical candidates. A strong positive correlation between the increase in ASV values and clinical improvement was observed.<\/jats:p><jats:p>\n          Conclusions\u2003PC-MRI can help in the management and follow-up of adult CM1 patients. Conservative management is possible in selected symptomatic CM1 patients with a high ASV (ASV\u2009&gt;\u200915 \u00b5L). Surgery should be considered in patients with an ASV \u2264 12 \u00b5L. CM1 patients with ASV \u226412 to &gt;15\u2009\u03bcL require close follow-up. Long-standing symptoms, severe sleep apnea, symptoms influencing functionality, and syrinx are factors that affected outcomes negatively.<\/jats:p>","DOI":"10.1055\/s-0042-1745845","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T22:42:17Z","timestamp":1657752137000},"page":"128-143","source":"Crossref","is-referenced-by-count":4,"title":["Management of Adult Chiari I Patients Based on CSF Flow Magnetic Resonance Imaging: Experience of Two Neurosurgical Centers"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3600-089X","authenticated-orcid":false,"given":"Anas","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9973-7130","authenticated-orcid":false,"given":"\u0130rfan","family":"\u00c7\u0131nar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aile Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1271-9023","authenticated-orcid":false,"given":"Meliha","family":"G\u00fcnda\u011f Papaker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Bezmialem Vakif University, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0937-831X","authenticated-orcid":false,"given":"Bet\u00fcl","family":"G\u00fcler Abdallah","sequence":"additional","affiliation":[{"name":"Department of Psychiatry - AMATEM Unit, University of Health Sciences, Bak\u0131rk\u00f6y Research and Training Hospital for Neurology Neurosurgery, and Psychiatry, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0584-9164","authenticated-orcid":false,"given":"Erhan","family":"Emel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Health Sciences, Bak\u0131rk\u00f6y Research and Training Hospital for Neurology Neurosurgery, and Psychiatry, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,13]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1007\/s11065-018-9368-6","article-title":"A systematic review of cognition in Chiari I malformation","volume":"28","author":"J M Rogers","year":"2018","journal-title":"Neuropsychol Rev"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3174\/ajnr.A2460","article-title":"CSF flow through the upper cervical spinal canal in Chiari I 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