Language
English
Publication Date
4-8-2024
Journal
American Journal of Neuroradiology
DOI
10.3174/ajnr.A8142
PMID
38485197
PMCID
PMC11288566
PubMedCentral® Posted Date
4-1-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Background and purpose: Outward convexity of the basiocciput and posterior atlanto-occipital membrane are common in patients with Chiari II malformation associated with an open neural tube defect. We aimed to determine if the severity of these findings correlated with the need for future hydrocephalus treatment.
Materials and methods: A retrospective chart and imaging review identified patients who underwent open neural tube defect repair at a quaternary care pediatric hospital from July 2014 through September 2022. Patients were classified by the need for hydrocephalus treatment and whether they received prenatal or postnatal neural tube defect repair. Measurements of imaging parameters related to posterior fossa maldevelopment and skull base remodeling were performed.
Results: Compared with 65 patients who did not require hydrocephalus treatment, 74 patients who required treatment demonstrated statistically significantly greater mean basiocciput convexity (P < .001). While the mean basiocciput length in the hydrocephalus treatment group was smaller (P < .001), the ratio of basiocciput convexity to length was larger (P < .001). Notably, 100% of patients with a basiocciput convexity of ≥4 mm required hydrocephalus treatment. The mean posterior atlanto-occipital membrane convexity was significantly greater for patients who required hydrocephalus treatment in the postnatal group (P = .02), but not the prenatal group (P = .09).
Conclusions: Pediatric patients with Chiari II malformation who ultimately required surgical hydrocephalus treatment had greater outward convexity of the basiocciput but had greater posterior atlanto-occipital membrane outward convexity only if the repair was performed postnatally. Together these measurements may be useful in predicting the need for hydrocephalus treatment.
Keywords
Pregnancy, Female, Humans, Child, Prognosis, Retrospective Studies, Arnold-Chiari Malformation, Hydrocephalus, Neural Tube Defects, Skull Base, Magnetic Resonance Imaging
Published Open-Access
yes
Recommended Citation
Freiling, John T; Desai, Nilesh K; Kralik, Stephen F; et al., "Prognostic Significance of Central Skull Base Remodeling in Chiari II Malformation" (2024). Faculty and Staff Publications. 5400.
https://digitalcommons.library.tmc.edu/baylor_docs/5400