Recognition of Cranio-Cervical Instability in the Complex Chiari ...

More documents

Recommendations

Info

¡ Within the population diagnosed with Chiari malformation, there is a subset of patients with “Complex Chiari ” ¡ The designation of Complex Chiari resides in the presence of additional anatomic or dynamic deformative stresses, which may be signaled by: clivo-‐axial angle 9 mm Harris > 12mm, or translation > 2mm on flexion extension Wholey’s BDI > 10mm Bull’s palato-‐atlantal angle > 13◦ Transgression of Lee’s X lines ¡ substantial clinical and neurobiological evidence links deformative stress of brainstem and spinal cord to the observed neurophysiological changes ¡ Complex Chiari should be watched for, and prompt consideration for additional evaluation with dynamic imaging
¡ Clair Francomano MD, GBMC , Assoc Prof, JHI ¡ Myles Koby MD, NIH, Doctors Hospital ¡ Micheal Adams, Engineering, Duke University ¡ Robert Gerwin MD Assoc Prof, JHI ¡ Ed Benzel MD-‐ Prof, Chair Neurosurg ,CCI ¡ Alex Vaccaro MD-‐ Prof Neurosurg Ortho, TJU ¡ Stephen Mott MD Assoc Prof Peds Neurol, Dartmouth ¡ Joel Berry PhD – Prof Chair Mech Eng, Kettering Univ ¡ Mark Alexander MD , Director Neuradiology Bethesda MRI ¡ William Wilson IV,Yale Univ ¡ Jessica Adcock MSc,Metropolitan Neurosurgery Grp
Page 1 and 2: Fraser C. Henderson Sr MD, Chief ,
Page 3 and 4: § A significant number of patients
Page 5 and 6: ¡ Discuss How deformative stress a
Page 7 and 8: Kitihara, Neurol Med Chir (Tokyo)19
Page 11 and 12: ¡ Clumping and loss of neurofilame
Page 13 and 14: Mouse optic nerve stretched 2mm (ε
Page 15 and 16: Calcium influx after stretch injury
Page 17 and 18: ¡ Mechanical forces modulate gene
Page 19 and 20: ¡ Compressed arrays of O2 saturati
Page 21 and 22: Neurosurgery: May 2005 - Volume 56
Page 23 and 24: “Loss of the ability of the spine
Page 25 and 26: 130° ABNORMAL Angulation of the br
Page 27 and 28: 130° ABNORMAL • Chiari decompres
Page 29 and 30: ¡ List 1941 ¡ Van Gilder 1985 ¡
Page 31 and 32: ¡ A line drawn along the hard pala
Page 34 and 35: ¡ basio to C1 posterior arch over
Page 36 and 37: ¡ Of 400 normal subjects, none had
Page 38 and 39: flexion-‐extension is the only
Page 40 and 41: Harris measurement = 12mm Harris me
Page 42 and 43: Mechanical stresses ¡ modulate gen
Page 44 and 45: Neurological assessment Sensory mot
Page 46 and 47: ¡ Neurological compression and ins
Page 48 and 49: 100 90 80 70 60 50 40 30 20 10 0 AS
Page 50 and 51: Surg Neurol Int. 2010; 1: 30. Publi

Recognition of Cranio-Cervical Instability in the Complex Chiari ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?