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Cranial Bones: Superior and Posterior View01:14

Cranial Bones: Superior and Posterior View

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The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
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Cranial Bones: Lateral View

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Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...

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Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
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Chiari malformation associated with craniosynostosis.

Jennifer Strahle1, Karin M Muraszko, Steven R Buchman

  • 1Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan 48709-5338, USA.

Neurosurgical Focus
|September 3, 2011
PubMed
Summary
This summary is machine-generated.

Chiari malformation (CM) is common in craniosynostosis patients, particularly with lambdoid or pansynostosis. Surgical repair of craniosynostosis can sometimes resolve CM and spinal cord syrinx, but de novo CM development can occur.

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Area of Science:

  • Neurosurgery
  • Pediatric Neurosurgery
  • Craniofacial Surgery

Background:

  • Chiari malformation (CM) Type I frequently co-occurs with craniosynostosis.
  • Optimal management strategies for CM in pediatric craniosynostosis patients remain unclear.

Purpose of the Study:

  • To report on a series of pediatric patients diagnosed with both craniosynostosis and CM.
  • To discuss the management and outcomes of these complex cases.

Main Methods:

  • Retrospective review of 383 patients treated for craniosynostosis over 15 years.
  • Identification of patients with concurrent CM, recording demographic and surgical data.
  • Analysis of MRI findings, including cerebellar tonsillar descent, hydrocephalus, and spinal syrinxes.

Main Results:

  • 29 patients with both conditions were identified; 52% had hydrocephalus, and 45% were syndromic.
  • CM was more prevalent in lambdoid (55%), multisuture (35%), and pansynostosis (80%) compared to coronal (6%) or sagittal (3%) synostosis.
  • Craniosynostosis repair alone improved CM in 5/7 patients, and spinal syrinx resolved in both cases. De novo CM developed in 5 patients post-repair.

Conclusions:

  • Chiari malformation is frequently associated with multi- and single-suture lambdoid craniosynostosis.
  • Craniofacial repair can lead to resolution of CM and spinal cord syrinx in some cases.
  • De novo development of CM following craniosynostosis repair is a notable occurrence.