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Cerebellar Tonsillar Ischemia and Cysts in the Chiari I Malformation

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The Chiari Malformations

Abstract

Rare reports in the literature have documented the presence of a cyst at the tip of the cerebellar tonsil in patients with Chiari I malformation. The authors prospectively reviewed all new Chiari I malformation (CM I) pediatric patients who presented to their clinic during a 2-year period. Specifically, all patients were screened for ischemic or cystic lesions of the herniated cerebellar tonsils on magnetic resonance imaging (MRI). Out of 340 patients, 2.9% were found to have signal changes on MRI consistent with ischemia or cysts in the cerebellar tonsils. For both ischemic and cystic cerebellar tonsils, histologically, the tissue demonstrated loss of Purkinje cells with concomitant Bergmann gliosis. Based on the findings, cerebellar tonsillar ischemia and cysts in patients with CM I can often be seen radiologically. Histologically, these ischemic and cystic tissues are the same. Taken together, cerebellar tonsillar ischemia and cysts are on a continuum and represent chronic compression of this herniated part of the cerebellum.

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References

  1. Koga H, Mukawa J, Nakata M, Miyazato H, Ishikawa Y, Sakuta O, Hokama A, Terada Y. Histopathological analysis of herniated cerebellar tonsils resected from the patients with Chiari type I malformation with syringomyelia. No To Shinkei. 1995;47:1075–9.

    CAS  PubMed  Google Scholar 

  2. Pueyrredon F, Spaho N, Arroyave I, Vinters H, Lazareff J. Histological findings in cerebellar tonsils of patients with Chiari type I malformation. Childs Nerv Syst. 2007;23:427–9.

    Article  Google Scholar 

  3. Stevenson CB, Leach JL, Gupta A, Crone KR. Cystic degeneration of the cerebellar tonsils in pediatric patients with Chiari Type I malformation: clinical article. J Neurosurg Pediatr. 2009;4:557–63.

    Article  Google Scholar 

  4. Rhoton AL Jr. Cerebellum and fourth ventricle. Neurosurgery. 2000;47:S7–S27.

    Article  Google Scholar 

  5. Jacob RP, Rhoton AL Jr. The Chiari I malformation. In: Anson JA, Benzel EC, Awad IA, editors. Syringomyelia and the Chiari malformations. Park Ridge: AANS; 1997. p. 51–67.

    Google Scholar 

  6. Welsh JP, Yuen G, Placantonakis DG, Vu TQ, Haiss F, O’Hearn E, Moliver ME, Aicher SA. Why do Purkinje cells die so easily after global brain ischemia? Aldolase C, EAAT4, and the cerebellar contribution to posthypoxic myoclonus. Adv Neurol. 2002;89:331–59.

    PubMed  Google Scholar 

  7. Allen G, Chase T. Induction of heat shock proteins and motor function deficits after focal cerebellar injury. Neuroscience. 2001;102:603–14.

    Article  CAS  Google Scholar 

  8. Fukuda K, Aihara N, Sagar S, Sharp F, Pitts L, Honkaniemi J. Purkinje cell vulnerability to mild traumatic brain injury. J Neurotrauma. 1996;5:255–65.

    Article  Google Scholar 

  9. Potts MB, Adwanikar H, Noble-Haeusslein LJ. Models of traumatic cerebellar injury. Cerebellum. 2009;8:211–21.

    Article  Google Scholar 

  10. Go KG, Hew JM, Kamman RL, Molenaar WM, Pruim J, Blaauw EH. Cystic lesions of the brain. A classification based on pathogenesis, with consideration of histological and radiological features. Eur J Radiol. 1993;17:69–84.

    Article  CAS  Google Scholar 

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Tubbs, R.S., Chern, J.J. (2020). Cerebellar Tonsillar Ischemia and Cysts in the Chiari I Malformation. In: Tubbs, R., Turgut, M., Oakes, W. (eds) The Chiari Malformations. Springer, Cham. https://doi.org/10.1007/978-3-030-44862-2_14

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  • DOI: https://doi.org/10.1007/978-3-030-44862-2_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44861-5

  • Online ISBN: 978-3-030-44862-2

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