{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:05:09Z","timestamp":1753891509623,"version":"3.41.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cough associated headache is the most common symptom in Chiari malformation type 1 (CM1). However, its pathophysiology and treatment are not clear. The aim of this study was to investigate the relationship between optic nerve sheath diameter (ONSD), an indicator of intracranial pressure, and headache and to investigate its predictive value on postoperative outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In symptomatic CM1 patients, craniovertebral junction morphometric measurements and ONSD measurements were made from preoperative MR images, and headache intensities and characteristics were evaluated. After different surgical procedures, the clinical characteristics of the patients were evaluated according to the Chicago Chiari Outcome Scale, the change in headache intensity was assessed and the relationship with ONSD was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preoperative headache intensity was significantly correlated with ONSD measurement (<jats:italic>p<\/jats:italic> &amp;lt; 0.01). Modified clivoaxial angle and ONSD were independent predictors of postoperative clinical outcome (<jats:italic>p<\/jats:italic> &amp;lt; 0.01). The procedure that achieved the greatest surgical enlargement of the foramen Magnum stenosis provided the best clinical outcome. Postoperative reduction in headache intensity and ONS diameter were correlated (<jats:italic>p<\/jats:italic> &amp;lt; 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The fact that ONSD is found to be wide in the preoperative period in CM1 patients indicates that the intracranial pressure is permanently high. This diameter increase is correlated with headache and is a valuable guide in the selection of the appropriate treatment method.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1127279","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T09:32:18Z","timestamp":1675762338000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The role of ONSD in the assessment of headache associated with Chiari malformation type 1"],"prefix":"10.3389","volume":"14","author":[{"given":"Mehmet K\u00fcr\u015fat","family":"Karadag","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Emin","family":"Akyuz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Hakan","family":"Sahin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.21037\/jss.2018.03.14","article-title":"Developments in the treatment of Chiari type 1 malformations over the past decade","volume":"4","author":"Passias","year":"2018","journal-title":"J Spine Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.wneu.2018.04.100","article-title":"Long-term outcomes of a new minimally invasive approach in Chiari type 1 and 15 malformations: technical note and preliminary results","volume":"115","author":"Kotil","year":"2018","journal-title":"World Neurosurgery."},{"key":"B3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.pediatrneurol.2019.12.005","article-title":"Prevalence and impact of underlying diagnosis and comorbidities on Chiari 1 malformation","volume":"106","author":"Sadler","year":"2020","journal-title":"Pediatr Neurol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s00701-020-04631-z","article-title":"Symptom outcome after craniovertebral decompression for Chiari type 1 malformation without syringomyelia","volume":"163","author":"Pepper","year":"2021","journal-title":"Acta Neurochir."},{"key":"B5","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3171\/jns.1994.80.1.0003","article-title":"Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils: implications for diagnosis and treatment","volume":"80","author":"Oldfield","year":"1994","journal-title":"J Neurosurg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1001\/archneur.1980.00500530064010","article-title":"Cough headache due to craniospinal pressure dissociation","volume":"37","author":"Williams","year":"1980","journal-title":"Arch Neurol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.neucir.2021.04.004","article-title":"Evaluation of third ventriculostomy outcome by measuring optic nerve sheath diameter in adult hdyrocephalus","volume":"33","author":"Aky\u00fcz","year":"2022","journal-title":"Neurocirug\u00eda"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1007\/s00134-011-2224-2","article-title":"Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis","volume":"37","author":"Dubourg","year":"2011","journal-title":"Intensive Care Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"262","DOI":"10.3171\/2020.2.PEDS19770","article-title":"Chiari type I malformation: role of the chiari severity index and Chicago Chiari outcome scale","volume":"26","author":"Ahluwalia","year":"2020","journal-title":"J Neurosurg Pediat."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"Headache classification committee of the international headache society (IHS) the international classification of headache disorders","volume":"38","author":"Arnold","year":"2018","journal-title":"Cephalalgia."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1007\/s00701-019-04100-2","article-title":"Chiari type 1\u2014a malformation or a syndrome? 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