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Evaluating CSF Flow (Cine MR) and Clinical Outcomes in Patients with Chiari Type 1 Who Underwent Dural Relaxation or
Durdu Mehmet Babaoğlan1, Mahmut Ferat1, İsmail İştemen1
1Department of Neurosurgery, Adana Faculty of Medicine, University of Health Sciences, Kisla Neighborhood, Dr. Mithat Ozsan Boulevard, 4522 Street No. 28, 01230 Adana, Türkiye.
Abstract:
Background: Cine magnetic resonance imaging (MRI) is increasingly used to evaluate abnormalities in the cerebrospinal fluid (CSF) flow in Chiari Malformation Type I (CM-I). However, its role in postoperative follow-up remains unclear. Methods: A retrospective analysis was performed on 58 CM-I patients who underwent foramen magnum decompression using dural relaxation or durotomy techniques. CSF flow velocities, measured using Cine MRI, were evaluated preoperatively and at one and six months postoperatively. Results: Postoperative CSF flow velocities were significantly increased in both follow-up periods compared to preoperative measurements (p < 0.001). The CSF flow velocity at six months postoperatively was also significantly higher than at one month postoperatively (p < 0.001). In patients with increased cerebrospinal fluid flow, the main VAS (Visual Analog Scale) score decreased and the SF-36 score increased, while growth was observed in areas where postoperative changes decreased, and these areas required reoperation. Conclusions: Dural relaxation or durotomy with foramen magnum decompression effectively improves CSF flow dynamics in CM-I patients. Cine MRI can provide valuable information regarding surgical adequacy and postoperative follow-up.