Relationship between basilar invagination and brachycephaly in Northeastern Brazil

Nascimento, José Jaílson Costa do; Carreiro, Nayyara M.F.; Oliveira, Gabriela T.; Ribeiro, Elayne C.O.; Holanda, Maurus M.A.; Neto, Eulâmpio J.S.; Araújo-Neto, Severino A.

doi:10.1016/j.ejrad.2018.05.006

Cited by 18 publications

(8 citation statements)

References 20 publications

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“…In further diagnostic accuracy studies, patients should have also their clinical neurological data, including a detailed physical examination, prospectively collected, since many clinical manifestations of BI are non-specific and it may not be suspected at all in the first medical evaluation. Fourth, the results of the present study cannot be extrapolated to BI type A, which has a distinct pathophysiology in comparison with BI type B [38,39]. Therefore, studies are still needed to evaluate the diagnostic accuracy of CVJ measurements in the BI type A.…”

Section: Discussionmentioning

confidence: 82%

Diagnostic accuracy of classical radiological measurements for basilar invagination of type B at MRI

et al. 2018

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Objective To evaluate the diagnostic accuracy of classical measurements for basilar invagination (BI) of type B at MRI. Methods This study used head MRIs from 31 participants with BI type B and 96 controls. The radiological criterion for BI was the odontoid process invagination using the obex as reference. It based on the independent prospective reading of two neuroradiologists. Concordance between the two neuroradiologists was analysed through the KAPPA index, and the discrepancy was resolved in a consensus meeting. A third examiner measured in two occasions (double blind) the distance of the odontoid apex to Chamberlain's line (DOCL) and McGregor's line (DOMG), clivus canal angle (CCA), Welcker's basal angle (WBA), and Boogaard's angle (BOA). Intra-examiner reproducibility of the measurements was evaluated with the intraclass correlation coefficient and the diagnostic accuracy by ROC curve. All analyses were at 95% confidence interval. Results Agreement between the two neuroradiologists was statistically relevant (KAPPA = .91; P = .0001). The intra-examiner reproducibilities were .98 (DOCL), .97 (DOMG), .96 (CCA), .94 (WBA), and .95 (BOA) (P < .05). The areas under the ROC curve were .963 (DOCL), .940 (DOMG), .880 (CCA), .867 (WBA), and .951 (BOA) (P < .05). The cut-off criteria were ≥ 7 mm (DOCL), ≥ 8 mm (DOMG), ≤ 145° (CCA), ≥ 142° (WBA), and ≥ 136° (BOA). The diagnostic accuracies were .904 (DOCL), .870 (DOMG), .844 (CCA), .810 (WBA), and .899 (BOA). Conclusion The DOCL and BOA presented the highest diagnostic accuracy for BI type B.

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Section: Discussionmentioning

confidence: 82%

Diagnostic accuracy of classical radiological measurements for basilar invagination of type B at MRI

et al. 2018

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“…14 A new systematic work identified an increased association of brachycephaly with BI. 2 This finding added new pathophysiologic factors in CCJM.…”

Section: Discussionmentioning

confidence: 89%

Association between Brachycephaly, Chiari Malformation, and Basilar Invagination

Botelho

Hernandez³

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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Background There is evidence that Chiari malformation (CM) and basilar invagination (BI) are largely due to disproportion between the content and volume of the posterior fossa. A recent study identified an increased association between brachycephaly and BI. In several types of craniosynostosis, the posterior fossa volume is smaller than normal, and this is more pronounced in coronal synostosis. The aim of this study is to evaluate the association between CM and BI. Methods The cephalic index (CI) measured on magnetic resonance imaging (MRI) from a sample of patients with craniocervical malformation was compared with that of normal subjects. Results The average CI in the craniovertebral junction malformation (CVJM) group was significantly higher in BI patients than in normal subjects. The BI patients also had the highest CI among the whole sample of patients (p = 0.009). Conclusions In this study, BI patients had the highest CI among patients with CVJM and a significantly higher CI than those in the control group. Our data confirm the association between BI and brachycephaly.

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“…BI is a prevalent condition in the Northeast of Brazil, associated with other craniometric changes such as platybasia and brachycephaly. [9][10][11]18,33,39] Chiari malformation is present in about 80% of these patients. With these characteristics, patients are classified as belonging to type B according to Goel's classification, and the deformity is considered irreducible based on the application of external traction.…”

Section: Discussionmentioning

confidence: 99%

Increase of the clivus-canal angle in patients with basilar invagination, without atlantoaxial displacement, treated with a simple maneuver of indirect decompression of the odontoid with the head clamp, during posterior occipitocervical arthrodesis

Vidal

Fonseca

Leimig

et al. 2021

Surgical Neurology International

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Background: Basilar invagination (BI) can be defined as the insinuation of the content of the craniovertebral junction through the foramen magnum toward the posterior fossa. BI is a prevalent condition in Northeast Brazil. The present study describes the changes in the clivus-canal angle (CCA) in the postoperative period in patients with symptomatic BI operated by a posterior approach, using a simple technique of indirect reduction of the odontoid associated with occipitocervical fixation. Methods: Patients underwent radiological evaluations by magnetic resonance imaging in the pre and postoperative periods, where the height of the odontoid tip was measured in relation to the Chamberlain line and the ACC. All patients underwent posterior occipitocervical fixation with specific maneuvers of distraction and extension of the cephalic segment with the aid of a head clamp with three fixation points for anterior reduction of the odontoid. Results: Among the 8 patients evaluated in the series, all had increased ACC in the postoperative period, with a mean of 14.81 ± 1.54°, and statistically significant difference between the pre and postoperative periods (P < 0.05). Conclusion: The indirect surgical reduction of the odontoid process by a posterior approach through the manipulation (distraction-extension) of a “Mayfield” type of head clamp followed by occipitocervical fixation proved to be effective in improving the ACC, being easily reproducible.

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Relationship between basilar invagination and brachycephaly in Northeastern Brazil

Cited by 18 publications

References 20 publications

Diagnostic accuracy of classical radiological measurements for basilar invagination of type B at MRI

Diagnostic accuracy of classical radiological measurements for basilar invagination of type B at MRI

Association between Brachycephaly, Chiari Malformation, and Basilar Invagination

Increase of the clivus-canal angle in patients with basilar invagination, without atlantoaxial displacement, treated with a simple maneuver of indirect decompression of the odontoid with the head clamp, during posterior occipitocervical arthrodesis

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