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The authors sought to develop a more automated tool to calculate the 3D posterior fossa volume, and correlate its changes after decompression with surgical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A semiautomated segmentation program was developed, and used to compare the pre- and postoperative volumes of the posterior cranial fossa (PCF) and the CSF spaces (cisterna magna, prepontine cistern, and fourth ventricle) in a cohort of pediatric patients with CM-I. Volume changes were correlated with postoperative symptomatic improvements in headache, syrinx, tonsillar descent, cervicomedullary kinking, and overall surgical success.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Forty-two pediatric patients were included in this study. The mean percentage increase in PCF volume was significantly greater in patients who showed clinical improvement versus no improvement in headache (5.89% vs 1.54%, p &lt; 0.05) and tonsillar descent (6.52% vs 2.57%, p &lt; 0.05). Overall clinical success was associated with a larger postoperative PCF volume increase (p &lt; 0.05). These clinical improvements were also significantly associated with a larger increase in the volume of the cisterna magna (p &lt; 0.05). The increase in the caudal portion of the posterior fossa volume was also larger in patients who showed improvement in syrinx (6.63% vs 2.58%, p &lt; 0.05) and cervicomedullary kinking (9.24% vs 3.79%, p &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>A greater increase in the postoperative PCF volume, and specifically an increase in the cisterna magna volume, was associated with a greater likelihood of clinical improvements in headache and tonsillar descent in patients with CM-I. Larger increases in the caudal portion of the posterior fossa volume were also associated with a greater likelihood of improvement in syrinx and cervicomedullary kinking.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.11.peds16263","type":"journal-article","created":{"date-parts":[[2017,2,17]],"date-time":"2017-02-17T14:57:22Z","timestamp":1487343442000},"page":"511-517","source":"Crossref","is-referenced-by-count":49,"title":["Comparison of posterior fossa volumes and clinical outcomes after decompression of Chiari malformation Type I"],"prefix":"10.3171","volume":"19","author":[{"given":"Siri Sahib S.","family":"Khalsa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Siu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, George Washington University;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffani A.","family":"DeFreitas","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children's National Health System, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin M.","family":"Cappuzzo","sequence":"additional","affiliation":[{"name":"George Washington University School of Medicine and Health Sciences; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Myseros","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children's National Health System, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh N.","family":"Magge","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children's National Health System, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chima O.","family":"Oluigbo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children's National Health System, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Keating","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children's National Health System, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds16263","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1227\/00006123-199508000-00004","article-title":"Posterior fossa volume and response to suboccipital decompression in patients with Chiari I malformation","volume":"37","author":"Badie B","year":"1995","unstructured":"Badie B, Mendoza D, Batzdorf U: Posterior fossa volume and response to suboccipital decompression in patients with Chiari I malformation. 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