{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:38:16Z","timestamp":1792809496125,"version":"4.5.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>In Chiari malformation type I (CM-I), a variety of imaging findings have been purported to be important; however, results have been inconclusive, inconsistent, or not replicated in independent studies. The purpose of this study was to report imaging characteristics for a large cohort of patients with CM-I and identify the imaging findings associated with surgical decompression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients were identified using ICD-9 codes for CM-I for the period from 1996 to 2017. After review of the medical records, patients were excluded if they 1) did not have a diagnosis of CM-I, 2) were not evaluated by a neurosurgeon, or 3) did not have available preoperative MRI. Retrospective chart review was performed to collect demographic and clinical data. Imaging parameters were measured according to the Chiari I Malformation Common Data Elements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 731 patients were included for analysis, having a mean follow-up duration of 25.5 months. The mean age at presentation was 8.5 years. The mean tonsil position was 11.4 mm below the foramen magnum, and 62.8% of patients had a pegged tonsil shape. Two hundred patients (27.4%) underwent surgery for life-dominating tussive headache, lower cranial nerve dysfunction, syrinx, and\/or brainstem dysfunction. Surgical treatment was associated with a syrinx (OR 20.4, 95% CI 12.3\u201333.3, p &lt; 0.0001), CM-1.5 (OR 1.797, 95% CI 1.08\u20132.98, p = 0.023), lower tonsil position (OR 1.130, 95% CI 1.08\u20131.18, p &lt; 0.0001), and congenital fusion of cervical vertebrae (OR 5.473, 95% CI 1.08\u201327.8, p = 0.040). Among patients with benign CM-I, tonsil position was statistically significantly associated with future surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Comprehensive imaging characteristics for a large cohort of patients with CM-I are reported. Analysis showed that a lower tonsillar position, a syrinx, and CM-1.5 were associated with undergoing posterior fossa decompression. This study demonstrates the importance of considering imaging findings in the context of patient symptomatology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.9.peds20347","type":"journal-article","created":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T03:20:23Z","timestamp":1619148023000},"page":"620-628","source":"Crossref","is-referenced-by-count":6,"title":["Imaging characteristics associated with surgery in Chiari malformation type I"],"prefix":"10.3171","volume":"27","author":[{"given":"Elizabeth N","family":"Alford","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis J","family":"Atchley","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tofey J","family":"Leon","sequence":"additional","affiliation":[{"name":"Departments of Internal Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M. 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