Posterior Fossa Dimensions of Chiari Malformation Patients Compared with Normal Subjects: Systematic Review and Meta-Analysis.

Autor: Botelho RV; Post-Graduate Program, Instituto de Assistência Médica ao Servidor Público do Estado de São Paulo, São Paulo, São Paulo, Brazil. Electronic address: bitbot@uol.com.br., Heringer LC; Post-Graduate Program, Instituto de Assistência Médica ao Servidor Público do Estado de São Paulo, São Paulo, São Paulo, Brazil., Botelho PB; Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, São Paulo, Brazil., Lopes RA; Post-Graduate Program, Instituto de Assistência Médica ao Servidor Público do Estado de São Paulo, São Paulo, São Paulo, Brazil., Waisberg J; Post-Graduate Program, Instituto de Assistência Médica ao Servidor Público do Estado de São Paulo, São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2020 Jun; Vol. 138, pp. 521-529.e2. Date of Electronic Publication: 2020 Mar 07.
DOI: 10.1016/j.wneu.2020.02.182
Abstrakt: Background: Chiari malformation (CM) is defined as a herniation of cerebellar tonsils below the foramen magnum and is considered to be due to underdevelopment of posterior fossa (PF) bone components. There is overcrowding of neural structures, and normal cerebrospinal fluid circulation is frequently blocked. Although several publications exist of measurements of dimensions and volumes from bone components of PF in CM, there is no systematic review evaluating quantitatively these dimensions. The aim of this study was to evaluate PF dimensions and volumes in a meta-analysis.
Methods: An electronic search using PubMed and Google Scholar was done. Study eligibility criteria were defined by the PICO strategy, which selected patients and interventions. Studies comparing PF dimensions between patients with CM and normal subjects were selected. A meta-analysis of pooled data was done using statistical software.
Results: Data for pooled analysis were obtained from 12 studies. Data synthesis was based on small published sample sizes in the majority of studies. Key findings included smaller measurements of clivus, supraoccipital bone, and PF area dimensions in patients with CM compared with normal subjects. Brainstem and cerebellar length was not different between groups.
Conclusions: This review provides evidence of smaller measurements of clivus, supraoccipital bone, and PF area dimensions in patients with CM compared with normal subjects. An implication of the key findings is that surgical treatment of CMs should consider the smaller dimensions of PF in planning.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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