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Related Experiment Videos

Tonsillar herniation on magnetic resonance imaging.

M Ishikawa1, H Kikuchi, I Fujisawa

  • 1Department of Neurosurgery, Kyoto University, Japan.

Neurosurgery
|January 1, 1988
PubMed
Summary
This summary is machine-generated.

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Tonsillar herniation risk was assessed using MRI. Displacement below the foramen magnum with loss of cerebrospinal fluid (CSF) space indicates herniation, especially with medullary compression.

Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Posterior fossa mass lesions and anomalies can risk tonsillar herniation.
  • Magnetic resonance imaging (MRI) is crucial for evaluating cerebellar tonsil position.

Purpose of the Study:

  • To evaluate the risk of tonsillar herniation in posterior fossa lesions.
  • To identify MRI signs indicative of tonsillar herniation.

Main Methods:

  • Investigated caudal pole of cerebellar tonsil using MRI in posterior fossa lesions and anomalies.
  • Analyzed T1-weighted sagittal images for tonsil position relative to the foramen magnum.
  • Compared 18 cases with lesions to 50 control cases.

Main Results:

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  • In controls, tonsils were typically at or near the foramen magnum; no herniation observed.
  • In 18 cases with posterior fossa lesions, 3 showed tonsillar displacement below the foramen magnum.
  • Displacement with anterior medullary compression and loss of CSF space correlated with rapid deterioration or papilledema.

    • Conclusions:

    • Tonsillar displacement below the foramen magnum with anterior medullary displacement and loss of CSF space is a sign of tonsillar herniation.
    • This sign is associated with significant clinical deterioration or increased intracranial pressure.
    • Chiari malformations with tonsillar displacement into the cervical canal but preserved CSF space showed less severe outcomes.