ObjectMany authors have concluded that the Chiari malformation Type I (CM-I) is due to a smaller than normal posterior cranial fossa. In order to establish this smaller geometry as the cause of hindbrain herniation in a family, the authors of this paper performed volumetric analysis in a family found to have this malformation documented in 4 generations.MethodsMembers from this family found to have a CM-I by imaging underwent volumetric analysis of their posterior cranial fossa using the Cavalieri method.ResultsNo member of this family found to have CM-I on preoperative imaging had a posterior fossa that was significantly smaller than that of age-matched controls.ConclusionsThe results of this study demonstrate that not all patients with a CM-I will have a reduced posterior cranial fossa volume. Although the mechanism for the development of hindbrain herniation in this cohort is unknown, this manifestation can be seen in multiple generations of a familial aggregation with normal posterior fossa capacity.
Based on our findings, the V2 part of the trigeminal nerve is not found bathed with venous blood within the cavernous sinus. Reports that state the contrary may have confused laterally positioned emissary veins as being part of the cavernous sinus and therefore erroneously concluded that V2 was within this cranial venous sinus. These data may prove useful to neurosurgeons that operate in the region of the cavernous sinus or to radiologists who interpret imaging of this area.
Altitude-related illnesses like high-altitude retinopathy result from rapid physiologic adaptation to altitude-induced hypoxia. These illnesses are typically experienced at altitudes above 3,000 m, with high-altitude retinal hemorrhages observed above 4,270 m. The patient participated in no strenuous physical activity but had severe enough retinal hypoxia from chemotherapy-induced anemia and thrombocytopenia that he experienced visually significant retinal hemorrhages. The occurrence of high-altitude retinopathy in such patients could portend the development of high-altitude cerebral edema at lower altitudes than traditionally reported and without exposure to known risk factors. Therefore, funduscopic examination should be performed on patients with anemia and thrombocytopenia who are complaining of decreased vision after traveling at high altitude.
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