{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:46:26Z","timestamp":1789670786215,"version":"4.0.1"},"reference-count":69,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The aim of this paper was to measure the posterior fossa (PF) volume increase resulting from a given-sized occipital craniectomy in Chiari malformation Type I surgery and to analyze its correlations with the PF size and the treatment response, with the perspective of tailoring the amount of bone removal to the patient-specific PF dimensions.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Between January 2005 and June 2006, 11 adult patients with symptomatic Chiari malformation Type I underwent a standardized PF decompression. A prospective evaluation with clinical examination, functional grading, and MR imaging measurement protocols was performed pre- and postoperatively. A method is reported for the measurement of PF volume (PFV) after surgery. The degree of PFV increase was compared with the preoperative size of the PF and with the clinical outcome.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>All 11 patients improved postoperatively, with complete and partial recovery in 4 and 7 patients, respectively. No postoperative complication occurred after a mean follow-up period of 45 months.<\/jats:p>\n<jats:p>The mean relative increase in PFV accounted for 10% (range 1.5%\u201319.7%) of the initial PFV; the increase was greater in cases in which the PF was small (r = \u22120.52, p = 0.09) and the basiocciput was short (r = \u22120.37, p = 0.2). A statistically significant positive correlation was found between the degree of PFV increase and the treatment response (p = 0.014); complete recovery was observed with a PFV increase of 15% and partial recovery with an increase of 7%.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The treatment response is significantly influenced by the degree of PFV increase, which is dependent on the size of the PF and the extent of the craniectomy, suggesting that the optimal patient-specific PFV increase could be predicted on the basis of preoperative MR imaging and enhancing the perspective that the craniectomy size could be tailored to the individual PFV.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.11.jns102148","type":"journal-article","created":{"date-parts":[[2011,2,4]],"date-time":"2011-02-04T15:00:00Z","timestamp":1296831600000},"page":"647-658","source":"Crossref","is-referenced-by-count":45,"title":["Posterior fossa volume increase after surgery for Chiari malformation Type I: a quantitative assessment using magnetic resonance imaging and correlations with the treatment response"],"prefix":"10.3171","volume":"115","author":[{"given":"R\u00e9my","family":"Noudel","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Gomis","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Sotoares","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Roger Salengro Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Bazin","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Pierot","sequence":"additional","affiliation":[{"name":"Neuroradiology, Maison Blanche Hospital, University of Reims;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pierre","family":"Pruvo","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Roger Salengro Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9gis","family":"Bordet","sequence":"additional","affiliation":[{"name":"Department of Predictive Medicine and Therapeutic Research, University of Lille; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Hugues","family":"Roche","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns102148","series-title":"J Comput Assist Tomogr","first-page":"1033","article-title":"Position of cerebellar tonsils in the normal population and in patients with Chiari malformation: a quantitative approach with MR imaging","volume":"9","author":"Aboulezz","year":"1985"},{"issue":"Suppl 1","key":"b2-jns102148","series-title":"Neurochirurgie","first-page":"81","article-title":"[Syringomyelia and intra-rachidian fluids. 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Implications for diagnosis and treatment","volume":"80","author":"Oldfield","year":"1994"},{"key":"b48-jns102148","series-title":"Neurosurgery","first-page":"945","article-title":"Syringomyelia persistence after Chiari decompression as a result of pseudomeningocele formation: implications for syrinx pathogenesis: report of three cases","volume":"43","author":"Par\u00e9","year":"1998"},{"key":"b49-jns102148","series-title":"Pediatr Neurosurg","first-page":"190","article-title":"Presentation and management of Chiari I malformation in children","volume":"26","author":"Park","year":"1997"},{"key":"b50-jns102148","series-title":"Acta Neurochir (Wien)","first-page":"1015","article-title":"Extraarachnoidal cranio-cervical decompression for syringomyelia associated with Chiari I malformation in adults: technique assessment","volume":"149","author":"Perrini","year":"2007"},{"key":"b51-jns102148","series-title":"Neurosurgery","first-page":"639","article-title":"Symptomatic Chiari malformation in adults: a new classification based on magnetic resonance imaging with clinical and prognostic significance","volume":"28","author":"Pillay","year":"1991"},{"key":"b52-jns102148","series-title":"Surgery of the Craniovertebral Junction","first-page":"507","article-title":"Management of Chiari malformations","author":"Rekate","year":"1998"},{"key":"b53-jns102148","series-title":"Pediatr Neurosurg","first-page":"186","article-title":"Recurrence of symptoms after Chiari decompression and duraplasty with nonautologous graft material","volume":"38","author":"Rosen","year":"2003"},{"key":"b54-jns102148","series-title":"Neurosurgery","first-page":"874","article-title":"Posterior fossa reconstruction: a surgical technique for the treatment of Chiari I malformation and Chiari I\/syringomyelia complex\u2014preliminary results and magnetic resonance imaging quantitative assessment of hindbrain migration","volume":"35","author":"Sahuquillo","year":"1994"},{"key":"b55-jns102148","series-title":"J Neurol Sci","first-page":"193","article-title":"The incidence of craniocervical bony anomalies in the adult Chiari malformation","volume":"82","author":"Schady","year":"1987"},{"key":"b56-jns102148","series-title":"J Child Neurol","first-page":"15","article-title":"Age-related changes in the relative growth of the posterior fossa","volume":"6","author":"Schaefer","year":"1991"},{"key":"b57-jns102148","series-title":"Cerebrospinal Fluid Res","first-page":"11","article-title":"Dimensions of the posterior fossa in patients symptomatic for Chiari I malformation but without cerebellar tonsillar descent","volume":"2","author":"Sekula","year":"2005"},{"key":"b58-jns102148","series-title":"Acta Neurochir (Wien)","first-page":"1005","article-title":"Cranio-cervical decompression for Chiari type I-malformation, adding extreme lateral foramen magnum opening and expansile duroplasty with arachnoid preservation. 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