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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(05): 405-408
DOI: 10.1590/0004-282X20160041
ARTICLE

3-D simulation of posterior fossa reduction in Chiari I

Simulação em 3D da redução da fossa posterior no Chiari do tipo I
Yvens Barbosa Fernandes
1   Hospital Municipal Mário Gatti, Departamento de Neurocirurgia, Campinas SP, Brasil;
3   Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brasil.
,
Pedro Fábio Mendonça Perestrelo
2   Centro de Tecnologia de Informação Renato Archer, Three Dimensional Technologies Division, Campinas SP, Brasil;
,
Pedro Yoshito Noritomi
2   Centro de Tecnologia de Informação Renato Archer, Three Dimensional Technologies Division, Campinas SP, Brasil;
,
Roger Neves Mathias
3   Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brasil.
,
Jorge Vicente Lopes da Silva
2   Centro de Tecnologia de Informação Renato Archer, Three Dimensional Technologies Division, Campinas SP, Brasil;
,
Andrei Fernandes Joaquim
1   Hospital Municipal Mário Gatti, Departamento de Neurocirurgia, Campinas SP, Brasil;
3   Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brasil.
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ABSTRACT

We proposed a 3D model to evaluate the role of platybasia and clivus length in the development of Chiari I (CI). Using a computer aided design software, two DICOM files of a normal CT scan and MR were used to simulate different clivus lengths (CL) and also different basal angles (BA). The final posterior fossa volume (PFV) was obtained for each variation and the percentage of the volumetric change was acquired with the same method. The initial normal values of CL and BA were 35.65 mm and 112.66º respectively, with a total PFV of 209 ml. Ranging the CL from 34.65 to 29.65 – 24.65 – 19.65, there was a PFV decrease of 0.47% – 1.12% – 1.69%, respectively. Ranging the BA from 122.66º to 127.66º – 142.66º, the PFV decreased 0.69% – 3.23%, respectively. Our model highlights the importance of the basal angle and clivus length to the development of CI.

RESUMO

No presente estudo, propusemos a criação de um modelo computacional em 3D com elaboração de software onde dois arquivos em formato DICOM com uma TC e RNM de crânio foram usados para simular diferentes mensurações na extensão do clivus (EC) e no ângulo basal (AB). O volume final da fossa posterior (VFP) foi obtido em cada variação, bem como a percentagem de volume alterada. O tamanho inicial da EC era de 35,65 mm e o do AB era de 112.66º, com um VFP de 209 ml. Variando a EC de 34,65 para 29,65 – 24.65 e 19.65, houve uma diminuição do VFP de 0.47%, 1.12% e 1.69%, respectivamente. Variando o AB de 122,66º para 127,66º e 142,66º, o VFP diminui para 0.69% e 3.23%, respectivamente. Nosso modelo enfatiza a importância da patogênese do aumento do AB e do encurtamento do clivus no desenvolvimento do Chiari I.

Chiari I - clivus length - platybasia - tonsillar herniation - 3D computational model
Chiari I - extensão do clivus - platibasia - herniação tonsilar - modelo computacional em 3D


Publication History

Received: 27 October 2015

Accepted: 24 February 2016

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Guo F, Wang M, Long J, Wang H, Sun H, Yang B et al. Surgical management of Chiari malformation: analysis of 128 cases. Pediatr Neurosurg. 2007;43(5):375-81. doi:10.1097/00013414-200306000-00005
  • 2 Joaquim AF, Fernandes YB, Mathias RN, Batista UC, Ghizoni E, Tedeschi H et al. Incidence of Basilar invagination in patients with Tonsillar herniation: a case control craniometrical study. Arq Neuropsiquiatr. 2014;72(9):706-11. doi:10.1590/0004-282X20140113
  • 3 Joaquim AF, Ghizoni E, Giacomini LA, Tedeschi H, Patel AA. Basilar invagination: Surgical results. J Craniovertebr Junction Spine. 2014;5(2):78-84. doi:10.4103/0974-8237.139202
  • 4 Goel A. Basilar invagination, Chiari malformation, syringomyelia: a review. Neurol India. 2009;57(3):235-46. doi:10.4103/0028-3886.53260
  • 5 Speer MC, Enterline DS, Mehltretter L, Hammock P, Joseph J, Dickerson M et al. Chiari type I malformation with or without syringomyelia: prevalence and genetics. J Genet Couns. 2003;12(4):297-311. doi:10.1023/A:1023948921381
  • 6 Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS. Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging. J Neurosurg. 2000;92(6):920-6. doi:10.3171/jns.2000.92.6.0920
  • 7 Fernandes YB, Ramina R, Campos-Herrera CR, Borges G. Evolutionary hypothesis for Chiari type I malformation. Med Hypotheses. 2013;81(4):715-9. doi:10.1016/j.mehy.2013.07.035
  • 8 Chiari H. Über Veränderungen des Kleinhirns infolge von Hydrocephalie des Grosshirns. Dtsch med Wschr. 1891;17:1172-75.
  • 9 Chiari H. Über Veränderungen des Kleinhirns, des Pons und der Medulla Oblongata in Folge von congenitaler Hydrocephalie des Grosshirns. Dtsch Akd Wissensch. 1895;63:71-125.
  • 10 Lieberman DE, Ross CF, Ravosa MJ. The primate cranial base: ontogeny, function and integration. Am J Phys Anthropol Suppl 2000;31:117-69.
  • 11 Lieberman DE. Sphenoid shortening and the evolution of modern human cranial shape. Nature. 1998; 393:158-62. doi:10.1038/30227
  • 12 Heiss JD, Suffredini G, Bakhtian KD, Sarntinoranont M, Oldfield EH. Normalization of hindbrain morphology after decompression of Chiari malformation Type I. J Neurosurg. 2012;117(5):942-6. doi:10.3171/2012.8.JNS111476
  • 13 Karagöz, F, Izgi, N, Kapíjcíjoğlu Sencer S. Morphometric measurements of the cranium in patients with Chiari Type I malformation and comparison with the normal population. Acta Neurochir (Wien). 2002;144(2):165-71. doi:10.1007/s007010200020