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Asymmetric laterality of Chiari type I malformation in patients with non-syndromic single-suture craniosynostosis

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Abstract

Background

Chiari type I malformation is a frequent incidental finding commonly associated with craniosynostosis. However, there seems to be a paucity of literature concerning the asymmetry of tonsillar herniation in patients with non-syndromic single-suture craniosynostosis.

Methods

To study the asymmetry in this cohort, measurements of the right and left tonsils were made from sagittal images from both pre-operative and post-operative images from 11 patients with non-syndromic single-suture craniosynostosis.

Results

Pre-operatively, the mean difference between the caudal descent of all tonsils ranged from 0 to 7 mm, with a mean difference between sides of 2.45 mm. In three cases, cerebellar tonsils were symmetrically herniated. Post-operatively, the mean difference between caudal descent of all tonsils ranged from 0 to 4 mm, with a mean difference between sides of 1.45 mm. Four were symmetrically herniated. In patients with non-syndromic single-suture craniosynostosis, the tonsillar herniation is asymmetric in the majority of cases.

Conclusions

Asymmetry of cerebellar tonsil herniation is a frequent finding in this cohort. The right tonsil is more inferiorly located in majority of cases, with predominance to the synostotic suture side in asymmetric craniosynostosis cases.

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Acknowledgments

This study was performed at Helsinki University Hospital.

Conflicts of interest

None.

Author contributions

All authors were equally involved in the study design, data analysis, and interpretation. VK wrote the first draft of the manuscript, and all authors were involved in critically revising the manuscript for important intellectual content. All authors approved the final version for publication.

Funding

Funding of this article was from departmental sources only.

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Authors and Affiliations

  1. Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland

    A. Karppinen

  2. Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland

    V. Koljonen

  3. Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland

    V. Koljonen

  4. Helsinki Medical Imaging Centre, Department of Radiology, Helsinki University Hospital, Helsinki, Finland

    L. Valanne

  5. Cleft Lip and Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland

    J. Leikola

  6. Department of Plastic Surgery, Töölö Hospital, PO Box 266, FIN 0029 HUS, Helsinki, Finland

    V. Koljonen

Authors
  1. A. Karppinen
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  2. V. Koljonen
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  3. L. Valanne
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  4. J. Leikola
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Corresponding author

Correspondence to V. Koljonen.

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Karppinen, A., Koljonen, V., Valanne, L. et al. Asymmetric laterality of Chiari type I malformation in patients with non-syndromic single-suture craniosynostosis. Acta Neurochir 154, 2103–2107 (2012). https://doi.org/10.1007/s00701-012-1470-6

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  • DOI: https://doi.org/10.1007/s00701-012-1470-6

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