Assessment of cerebellar pulsation in dogs with and without Chiari-like malformation and syringomyelia using cardiac-gated cine magnetic resonance imaging

Driver, Colin; Watts, V.; Bunck, Alexander C.; Ham, Luc M. Van; Volk, Holger A.

doi:10.1016/j.tvjl.2013.05.017

Cited by 22 publications

(22 citation statements)

References 26 publications

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“…11,44,48,53,59 However, in the somewhat analogous canine CLM, only a subgroup of the CLM animals (those with syringomyelia) demonstrated significantly increased motion over control animals. 16 Whether differences between the human and canine conditions or differences between dog breeds (control group) explain these differences is unknown. Since tonsillar ectopia length (the current CM-I diagnostic marker) correlates poorly with clinical symptoms, 57 further studies should investigate if cerebellar tonsillar motion may have use as an adjunct marker of CM-I.…”

Section: Cerebellar Tonsillar Motion In Cm-i Patients and Controlsmentioning

confidence: 99%

“…Different degrees of head flexion between (but not within) our subjects in comparison with Driver et al's canine groups may also account for the dissimilar results. Interestingly, the average tonsillar motion (CLM/CM-I with syrinx values given) was much greater and more variable in dogs (4.18 ± 2.63 mm according to Driver et al 16 ) than that in humans (current study 0.81 ± 0.47 mm; Bunck et al 5 1.0 ± 0.6 mm; Cousins and Haughton 11 0.61 ± 0.03 mm) despite similar or smaller degrees of herniation. 12,14,31 Whether increased cerebellar motion has a different effect on the canine system is unknown.…”

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confidence: 95%

“…39 Cine bFFE is suitable for neuroimaging, 36,45,55 and specific applications to that manual measurement of cerebellar tonsillar motion demonstrated substantial to near-perfect reliability. 48 Driver et al 16 assessed cerebellar motion using cine bFFE in a related canine condition, Chiari-like malformation (CLM). Pulsation of the entire neuraxis was observed, and cerebellar movement was significantly greater in CLM animals with syringomyelia than those without syrinxes and the control group.…”

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confidence: 99%

“…16 Whether anesthesia or other differences between humans and dogs influenced these findings is unclear. Different degrees of head flexion are known to alter cerebellar herniation length in CLM, 56 and it is unknown if this is true for CM-I or cerebellar tonsillar motion in humans.…”

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confidence: 99%

“…No anecdotal or experimental observations suggest that tonsillar motion changes over time, although this has been speculated in canine CLM. 16 Longitudinal studies that follow CM-I patients as they develop syringomyelia may provide insight into whether any changes to cerebellar motion occur with time and whether this contributes to syringomyelia pathogenesis.…”

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confidence: 99%

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Cerebellar and hindbrain motion in Chiari malformation with and without syringomyelia

Leung

Magnussen

Stoodley

et al. 2016

SPI

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OBJECTIVE The pathogenesis of syringomyelia associated with Chiari malformation type I (CM-I) is unclear. Theories of pathogenesis suggest the cerebellar tonsils may obstruct CSF flow or alter pressure gradients, or their motion might act as a piston to increase CSF pressure in the spinal subarachnoid space. This study was performed to measure cerebellar tonsillar and hindbrain motion in CM-I and assess the potential contributions to syrinx formation. METHODS Sixty-four CM-I patients and 25 controls were retrospectively selected from a clinical database, and all subjects had undergone cardiac-gated cine balanced fast-field echo MRI. There were a total of 36 preoperative CM-I scans, which consisted of 15 patients with and 21 patients without syringomyelia. Nineteen patients underwent paired pre- and postoperative imaging. Anteroposterior (AP) and superoinferior (SI) movements of the tip of the cerebellar tonsils, obex, fastigium of the fourth ventricle, pontomedullary junction, and cervicomedullary junction were measured. The distance between the fastigium and tip of the tonsils was used to calculate tonsillar tissue strain (Δi/i0). RESULTS CM-I patients had significantly greater cerebellar tonsillar motion in both the AP and SI directions than controls (AP +0.34 mm [+136%], p < 0.001; SI +0.49 mm [+163%], p < 0.001). This motion decreased after posterior fossa decompression (AP −0.20 mm [−33%], p = 0.001; SI −0.29 mm [−36%]; p < 0.001), but remained elevated above control levels (AP +56%, p = 0.021; SI +67%, p = 0.015). Similar trends were seen for all other tracked landmarks. There were no significant differences in the magnitude or timing of motion throughout the hindbrain between CM-I patients with and without syringomyelia. Increased tonsillar tissue strain correlated with Valsalva headaches (p = 0.03). CONCLUSIONS Cerebellar tonsillar motion may be a potential marker of CM-I and may have use in tailoring surgical procedures. The lack of association with syringomyelia suggests that tonsillar motion alone is not the driver of syrinx formation. Tonsillar tissue strain may play a part in the pathophysiology of Valsalva headaches.