Wolpert S M, Scott R M, Platenberg C, Runge V M
Department of Radiology, New England Medical Center Hospital, Boston, MA 02111.
AJNR Am J Neuroradiol. 1988 Nov-Dec;9(6):1075-8.
This study investigates whether the degree of brainstem herniation and the nature of the cervicomedullary deformity seen on sagittal plane MR images correlates with the clinical syndrome in patients with the Chiari II malformation. The amount of brainstem herniation was assessed by relating the position of the midbrain and pons to the sella turcica and the anterior lip of the foramen magnum, respectively. The cervicomedullary deformity was graded into degrees of increasing severity. We found that the neurologic status of these children was not affected by either the amount of herniation or the characteristics of the cervicomedullary deformities. Because of these findings, we believe that other factors, such as disorganization of the brainstem nuclei, may be the likely cause for the breathing and swallowing difficulties experienced by children with the Chiari II malformation.
本研究调查矢状面磁共振成像（MR）上所见的脑干疝程度及颈髓畸形性质是否与Chiari II型畸形患者的临床综合征相关。通过分别将中脑和脑桥的位置与蝶鞍及枕骨大孔前缘相关联来评估脑干疝的程度。颈髓畸形分为严重程度递增的等级。我们发现这些儿童的神经状态不受疝的程度或颈髓畸形特征的影响。基于这些发现，我们认为其他因素，如脑干核团紊乱，可能是Chiari II型畸形儿童出现呼吸和吞咽困难的可能原因。
