{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:01:53Z","timestamp":1787025713674,"version":"build-2736575974"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>One of the feared consequences of craniovertebral junction diseases is apnea. Although several cases of patients with central apnea have been described, obstructive sleep apnea has been identified as the most frequent manifestation of sleep respiratory disorder. Neuronal involvement may be responsible for both central and obstructive apneas. The objective of this work was to study the effect of posterior fossa decompressive surgery on respiratory parameters during sleep in patients with craniovertebral junction malformations and breathing-related sleep disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, prospectively enrolled consecutive symptomatic adult patients were monitored with full-night polysomnography before and after surgical decompression of the cranial posterior fossa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 25 patients who were evaluated, 68% received a diagnosis of sleep apnea. After surgery, the mean number of respiratory events decreased from 180.70 to 69.29 (p = 0.005); the mean number of obstructive events decreased from 107.37 to 60.58 (p = 0.01); and the mean number of central events decreased from 38.45 to 8.05 (p = 0.01). The mean preoperative apnea\/hypopnea index decreased from 26.68 to 12.98 (p = 0.06), and the mean central apnea index decreased from 13.81 to 1.68 (p = 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Decompressive surgery in patients with craniovertebral junction malformations resulted in decreased respiratory events during sleep, lowered sleep fragmentation, and enhanced the sleep apnea index in a significant number of patients. The effect was more pronounced in patients with central apnea.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2009.7.jns09174","type":"journal-article","created":{"date-parts":[[2009,8,7]],"date-time":"2009-08-07T08:12:58Z","timestamp":1249632778000},"page":"800-807","source":"Crossref","is-referenced-by-count":38,"title":["The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea"],"prefix":"10.3171","volume":"112","author":[{"given":"Ricardo Vieira","family":"Botelho","sequence":"first","affiliation":[{"name":"Neurosurgical Service, Hospital do Servidor publico do Estado de S\u00e3o Paulo; and"},{"name":"Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de S\u00e3o Paulo-UNIFESP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia Rita Azeredo","family":"Bittencourt","sequence":"additional","affiliation":[{"name":"Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de S\u00e3o Paulo-UNIFESP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Marcus","family":"Rotta","sequence":"additional","affiliation":[{"name":"Neurosurgical Service, Hospital do Servidor publico do Estado de S\u00e3o Paulo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9rgio","family":"Tufik","sequence":"additional","affiliation":[{"name":"Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de S\u00e3o Paulo-UNIFESP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1120800","series-title":"Eur Respir J","first-page":"661","article-title":"Acute respiratory failure as the first sign of Arnold\u2013Chiari malformation associated with syringomyelia","volume":"8","author":"Alvarez","year":"1995"},{"key":"b2-1120800","series-title":"Sleep","first-page":"173","article-title":"EEG arousals: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association","volume":"15","author":"Anonymous","year":"1992"},{"key":"b3-1120800","series-title":"Neurosurgery","first-page":"1069","article-title":"Chiari I malformation: classification and management","volume":"37","author":"Bindal","year":"1995"},{"key":"b4-1120800","series-title":"N Engl J Med","first-page":"947","article-title":"Impaired peripheral chemosensitivity and acute respiratory failure in Arnold\u2013Chiari malformation and syringomyelia","volume":"288","author":"Bokinsky","year":"1973"},{"key":"b5-1120800","series-title":"J Bras Neurocir","first-page":"111","article-title":"Apn\u00e9ia do sono central em paciente com malforma\u00e7\u00e4o de Chiari tipo I e siringomielia: tratamento com cirurgia descompressiva. 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