Impact of morphological measurements on symptoms in Chiari malformation type 1



Chiari I malformation, Magnetic resonance imaging, Posterior cranial fossa, Tonsillar herniation


Aim: Chiari malformation Type 1 (CM1) is a pathology resulting from herniation of cerebellar tonsils or tonsils into the spinal canal. We aimed to examine the impact of the cranium’s morphological measurements on the symptoms with CM1 patients.

Methods: This research was designed as a retrospective case-control study in a single-center. 2309 patients aged between 18-70 who underwent brain magnetic resonance imaging (MRI) to confirm or exclude the diagnosis of CM1 as a result of clinical and examination findings were evaluated. Cranium’s morphological measurements, the amount of herniation, patient’s symptoms, and the modified Asgari score were retrospectively assessed. 

Results: Patients with a final diagnosis of CM1 after the MRI evaluation were classified as study group (n=212), and the others control group (n=2097). The maximum cranial length, maximum cranial height, supra occiput length, posterior cranial fossa (PCF) anteroposterior length, in the study group were shorter, whereas the sagittal diameter of the foramen magnum and the longest anteroposterior diameter of the cerebrum were longer (P<0.001 for all mentioned comparisons). Tentorium cerebelli slope was found to be significantly lower in the study group (P<0.001). The most prevalent symptoms were a headache (92%). The herniation amount had a negative correlation with maximum cranial length and maximum cranial height (r=-0.184, P=0.07; r=-0.158 and P=0.022, respectively) and a positive correlation with the modified Asgari score (r=0.598; P<0.001).

Conclusion: The cranium’s morphological measurements have an impact on the symptoms of patients with CM1.


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Research Article

How to Cite

Kavak RP, Özdemir M, Sorar M. Impact of morphological measurements on symptoms in Chiari malformation type 1. J Surg Med [Internet]. 2019 Jun. 28 [cited 2024 Apr. 14];3(6):441-6. Available from: