Posterior Cranial Fossa Volume in Patients with Rickets: Insights into the Increased Occurrence of Chiari I Malformation in Metabolic Bone Disease

Tubbs, R. Shane; Webb, Daniel; Abdullatif, Hussein; Conklin, Michael; Doyle, Scott; Oakes, W. Jerry

doi:10.1227/01.neu.0000129547.30778.b7

Cited by 42 publications

(26 citation statements)

References 21 publications

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“…[5][6][7][8][9] These alterations in bone development produce a reduction in both growth velocity and height, with a higher frequency of scoliosis, leg curvature and cranial deformities. [10][11][12][13][14][15][16][17] Some researchers have recently suggested that 5 min per day, 5 times per week for 4 weeks of passive exercises with soft compressions result in increased bone mineral density (BMD) in very low birth weight premature infants. [18][19][20][21] This prospective randomized controlled clinical assay was carried out with the objective of evaluating the effects of a motor physical therapy protocol, 15 min per day, 5 days per week, on bone mineralization in very low birth weight preterm infants.…”

Section: Introductionmentioning

confidence: 99%

Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study

2008

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Objective: To study the effect of physical therapy on bone mineralization, weight gain and growth in preterm infants.Method: After fulfilling the inclusion criteria, preterm infants were matched for gestational age and birth weight and then randomly assigned to the physiotherapy group (PG, n ¼ 15) and control group (CG, n ¼ 14). The PG received motor physical therapy for 15 min daily, 5 times per week until hospital discharge. Bone mineralization was measured by total body dual energy X-ray beam absorptiometry (DEXA) at the onset and end of the study. Statistical analysis was realized by ANCOVA and linear correlation tests. Result:The physical therapy group (PG) presented greater body weight gain per day (27.4 ± 2.4 vs 21.01 ± 4.4 g, P<0.001) and length (1.3 ± 0.3 vs 0.8 ± 0.2 cm week À1 , P<0.001) than did the control group (CG). Body composition values verified by DEXA were greater for the PG. The mean gain in bone mineral content (BMC) (mg) was greater in the PG (434±247.5 vs À8.9±11.4, P<0.001), as was the mean bone mineral density (BMD) gain (mg cm À2 ) (8.4 ± 5.6 vs À3.1 ± 5.5, P<0.001). The gain in bone area (BA,cm 2 ) was 10.3±5 in the PG vs 1.5 ± 2 in the CG (P<0.001). The gain in lean mass (LM) (g) in the PG was also greater than in the CG (271.1±21.4 vs 109.1±1.0, P<0.009). The fat mass (g) was similar between the groups (P ¼ 0.432). Conclusion:These results showed that physiotherapy in preterm infants produced greater gains in growth, body weight, BMC, BMD, BA and LM.

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Section: Introductionmentioning

confidence: 99%

Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study

2008

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“…The posterior fossa volume in this case was 117.9 cm 3 . This volume is well below aged-matched controls (11- to 15-year-olds) which were 123–173 cm 3 with a mean of 148 cm 3 in one study [4. ]…”

Section: Case Reportmentioning

confidence: 84%

“…The points were counted and a volume calculation was made from the formula: posterior fossa volume = ( t )( Ap ) 2 (Σ Pi ), where t is the distance between the axial slices in cm, Ap is the anatomic distance between the dots of the grid, and Σ Pi is the total number of dots counted on the axial slices. The limits of the posterior fossa were that of what Tubbs et al [4] described in their calculations of posterior fossa volumes in children with rickets. The posterior fossa volume in this case was 117.9 cm 3 .…”

Section: Case Reportmentioning

confidence: 99%

Pentasomy 49,XXXXY Associated with a Chiari Type 1 Malformation and Cervical Syrinx

Raven

Bingham²,

Graupman³

2006

Pediatr Neurosurg

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Pentasomy 49,XXXXY occurs in 1/85,000 newborn males. The origin of this particular form of aneuploidy is believed to be a result of consecutive nondisjunction events during maternal meiosis. Typical presentation consists of hypotonia, developmental delay, various dysmorphic features, and severe hypogenitalism. A 13-year-old with pentasomy 49,XXXXY and a Chiari type 1 malformation with an associated cervical syrinx is presented.

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“…3 Rickets may be associated with a variety of cranial bone disorders -craniosynostosis and the presence of cerebellar tonsillar descent being the most notablethat can result in an increase in intracranial pressure. [4][5][6][7][8][9][10] In our patient there was a suspicion of intracranial hypertension associated with XLH. Unfortunately, a lumbar puncture with measurement of the opening pressure could not be performed, as this procedure is considered to be dangerous in patients with an existing cerebellar tonsillar descent.…”

Section: Discussionmentioning

confidence: 99%

Patulous Subarachnoid Space of the Optic Nerve Associated with X-Linked Hypophosphatemic Rickets

Galvez-Ruiz

Chaudhry

2013

Neuro-Ophthalmology

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Although the deficiency forms are the most common manifestations of rickets, there are other forms of rickets that are resistant to vitamin D. Of these, the most common is X-linked hypophosphatemic rickets. Rickets represents a group of multiple cranial bone disorders-craniosynostosis and the presence of Chari I malformation being the most notable-that explain the increase in intracranial pressure. We present a 4-yearold patient with an unusual association of X-linked hypophosphataemic rickets, bilateral proptosis, and prominent bilateral widening of the optic nerve sheaths. Although the association between intracranial hypertension and rickets is known, to the best of our knowledge, such a prominent distention of the subarachnoid space of the optic nerve without papilloedema has not been previously described.

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Posterior Cranial Fossa Volume in Patients with Rickets: Insights into the Increased Occurrence of Chiari I Malformation in Metabolic Bone Disease

Cited by 42 publications

References 21 publications

Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study

Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study

Pentasomy 49,XXXXY Associated with a Chiari Type 1 Malformation and Cervical Syrinx

Patulous Subarachnoid Space of the Optic Nerve Associated with X-Linked Hypophosphatemic Rickets

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