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Predictive Analysis in Chiari Malformation Type I

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The Chiari Malformations
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Abstract

It has become increasingly accepted that the various facets of medicine are not deterministic. Clinicians must weigh not just a set of fixed benchmarks while determining optimal patient care but must also incorporate a growing set of health data generated by their patients. The future of personalized healthcare lies in predictive analytics that utilizes algorithmically derived probabilities to augment patient care. Such an approach has immense potential in a condition such as Chiari I malformation that is characterized by heterogeneous presentations, management options, and postsurgical outcomes. The authors review various predictors identified in relation to CM I and discuss the findings and relevance of two novel algorithms in predicting outcome after CM I surgery.

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References

  1. Senders JT, Staples PC, Karhade AV, Zaki MM, Gormley WB, Broekman MLD, et al. Machine learning and neurosurgical outcome prediction: a systematic review. World Neurosurg. 2018;109:476–86.

    Article  PubMed  Google Scholar 

  2. Moisi MD, Page J, Gahramanov S, Oskouian RJ. Bullet fragment of the lumbar spine: the decision is more important than the incision. Global Spine J. 2015;5(6):523–6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Arle JE, Perrine K, Devinsky O, Doyle WK. Neural network analysis of preoperative variables and outcome in epilepsy surgery. J Neurosurg. 1999;90(6):998–1004.

    Article  CAS  PubMed  Google Scholar 

  4. Emblem KE, Pinho MC, Zöllner FG, Due-Tonnessen P, Hald JK, Schad LR, et al. A generic support vector machine model for preoperative glioma survival associations. Radiology. 2015;275(1):228–34.

    Article  PubMed  Google Scholar 

  5. Knoll MA, Oermann EK, Yang AI, Paydar I, Steinberger J, Collins B, et al. Survival of patients with multiple intracranial metastases treated with stereotactic radiosurgery: does the number of tumors matter? Am J Clin Oncol. 2018;41(5):425–31.

    Article  PubMed  Google Scholar 

  6. Hoffman H, Lee SI, Garst JH, Lu DS, Li CH, Nagasawa DT, et al. Use of multivariate linear regression and support vector regression to predict functional outcome after surgery for cervical spondylotic myelopathy. J Clin Neurosci. 2015;22(9):1444–9.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Azimi P, Mohammadi HR, Benzel EC, Shahzadi S, Azhari S. Use of artificial neural networks to predict recurrent lumbar disk herniation. J Spinal Disord Tech. 2015;28(3):E161–5.

    Article  PubMed  Google Scholar 

  8. Lo BW, Macdonald RL, Baker A, Levine MA. Clinical outcome prediction in aneurysmal subarachnoid hemorrhage using Bayesian neural networks with fuzzy logic inferences. Comput Math Methods Med. 2013;2013:904860.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Azimi P, Mohammadi HR. Predicting endoscopic third ventriculostomy success in childhood hydrocephalus: an artificial neural network analysis. J Neurosurg Pediatr. 2014;13(4):426–32.

    Article  PubMed  Google Scholar 

  10. Oermann EK, Rubinsteyn A, Ding D, Mascitelli J, Starke RM, Bederson JB, et al. Using a machine learning approach to predict outcomes after radiosurgery for cerebral arteriovenous malformations. Sci Rep. 2016;6:21161.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Chiari H. Über Veränderungen des Kleinhirns, des Pons und der Medulla Oblangata in Folge von kongenitaler Hydrocephalie des Grosshirns. Denkschriften Akad Wiss Wien. 1896;63:71–116. Germanica.

    Google Scholar 

  12. Chiari H. Über veränderungen des kleinhirns in folge von hydrocephales des grosshirns. Dtsch Med Wochenschr. 1891;17:1172–5. Germanica.

    Google Scholar 

  13. Iskandar BJ, Hedlund GL, Grabb PA, Oakes WJ. The resolution of syringohydromyelia without hindbrain herniation after posterior fossa decompression. J Neurosurg. 1998;89:212–6.

    Article  CAS  PubMed  Google Scholar 

  14. Tubbs RS, Iskandar BJ, Bartolucci AA, Oakes WJ. A critical analysis of the Chiari 1.5 malformation. J Neurosurg. 2004;101(2 Suppl):179–83.

    PubMed  Google Scholar 

  15. Urbizu A, Martin BA, Moncho D, Rovira A, Poca MA, Sahuquillo J, et al. Machine learning applied to neuroimaging for diagnosis of adult classic Chiari malformation: role of the basion as a key morphometric indicator. J Neurosurg. 2018;129(3):779–91.

    Article  PubMed  Google Scholar 

  16. Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, et al. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1999;44(5):1005–17.

    Article  CAS  PubMed  Google Scholar 

  17. Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS. Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging. J Neurosurg. 2000;92:920–6.

    Article  CAS  PubMed  Google Scholar 

  18. Tubbs RS, Beckman J, Naftel RP, Chern JJ, Wellons JC 3rd, Rozzelle CJ, et al. Institutional experience with 500 cases of surgically treated pediatric Chiari malformation Type I. J Neurosurg Pediatr. 2011;7(3):248–56.

    Article  PubMed  Google Scholar 

  19. McVige JW, Leonardo J. Imaging of Chiari type I malformation and syringohydromyelia. Neurol Clin. 2014;32(1):95–126.

    Article  PubMed  Google Scholar 

  20. Rogers JM, Savage G, Stoodley MA. A systematic review of cognition in Chiari I malformation. Neuropsychol Rev. 2018;28(2):176–87.

    Article  PubMed  Google Scholar 

  21. Roohi F, Gropen T, Kula RW. Sudden unexpected nocturnal death in Chiari type 1 malformation and potential role of opioid analgesics. Surg Neurol Int. 2014;5:17.

    Article  PubMed  PubMed Central  Google Scholar 

  22. McGirt MJ, Attenello FJ, Atiba A, Garces-Ambrossi G, Datoo G, Weingart JD, et al. Symptom recurrence after suboccipital decompression for pediatric Chiari I malformation: analysis of 256 consecutive cases. Childs Nerv Syst. 2008;24:1333–9.

    Article  PubMed  Google Scholar 

  23. Nagoshi N, Iwanami A, Toyama Y, Nakamura M. Factors contributing to improvement of syringomyelia after foramen magnum decompression for Chiari type I malformation. J Orthop Sci. 2014;19:418–23.

    Article  PubMed  Google Scholar 

  24. Navarro R, Olavarria G, Seshadri R, Gonzales-Portillo G, McLone DG, Tomita T. Surgical results of posterior fossa decompression for patients with Chiari I malformation. Childs Nerv Syst. 2004;20:349–56.

    Article  PubMed  Google Scholar 

  25. Park YS, Kim DS, Shim KW, Kim JH, Choi JU. Factors contributing improvement of syringomyelia and surgical outcome in type I Chiari malformation. Childs Nerv Syst. 2009;25:453–9.

    Article  PubMed  Google Scholar 

  26. Wu T, Zhu Z, Jiang J, Zheng X, Sun X, Qian B, et al. Syrinx resolution after posterior fossa decompression in patients with scoliosis secondary to Chiari malformation type I. Eur Spine J. 2012;21:1143–50.

    Article  PubMed  Google Scholar 

  27. Ladner TR, Dewan MC, Day MA, Shannon CN, Tomycz L, Tulipan N, et al. Evaluating the relationship of the pB-C2 line to clinical outcomes in a 15-year single-center cohort of pediatric Chiari I malformation. J Neurosurg Pediatr. 2015;15:178–88.

    Article  PubMed  Google Scholar 

  28. Tubbs RS, Webb DB, Oakes WJ. Persistent syringomyelia following pediatric Chiari I decompression: radiological and surgical findings. J Neurosurg. 2004;100(5 Suppl Pediatrics):460–4.

    Google Scholar 

  29. Hekman KE, Aliaga L, Straus D, Luther A, Chen J, Sampat A, et al. Positive and negative predictors for good outcome after decompressive surgery for Chiari malformation type 1 as scored on the Chicago Chiari Outcome Scale. Neurol Res. 2012;34:694–700.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Attal N, Parker F, Tadié M, Aghakani N, Bouhassira D. Effects of surgery on the sensory deficits of syringomyelia and predictors of outcome: a long term prospective study. J Neurol Neurosurg Psychiatry. 2004;75:1025–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Dyste GN, Menezes AH, VanGilder JC. Symptomatic Chiari malformations. An analysis of presentation, management, and long-term outcome. J Neurosurg. 1989;71:159–68.

    Article  CAS  PubMed  Google Scholar 

  32. Chavez A, Roguski M, Killeen A, Heilman C, Hwang S. Comparison of operative and non-operative outcomes based on surgical selection criteria for patients with Chiari I malformations. J Clin Neurosci. 2014;21:2201–6.

    Article  PubMed  Google Scholar 

  33. Greenberg JK, Yarbrough CK, Radmanesh A, Godzik J, Yu M, Jeffe DB, et al. The Chiari severity index: a preoperative grading system for Chiari malformation type 1. Neurosurgery. 2015;76:279–85.

    Article  PubMed  Google Scholar 

  34. McGirt MJ, Nimjee SM, Fuchs HE, George TM. Relationship of cine phase-contrast magnetic resonance imaging with outcome after decompression for Chiari I malformations. Neurosurgery. 2006;59:140–6.

    Article  PubMed  Google Scholar 

  35. Badie B, Mendoza D, Batzdorf U. Posterior fossa volume and response to suboccipital decompression in patients with Chiari I malformation. Neurosurgery. 1995;37:214–8.

    Article  CAS  PubMed  Google Scholar 

  36. Furtado SV, Thakar S, Hegde AS. Correlation of functional outcome and natural history with clinicoradiological factors in surgically managed pediatric Chiari I malformation. Neurosurgery. 2011;68:319–28.

    Article  PubMed  Google Scholar 

  37. Alperin N, Loftus JR, Bagci AM, Lee SH, Oliu CJ, Shah AH, et al. Magnetic resonance imaging-based measures predictive of short-term surgical outcome in patients with Chiari malformation Type I: a pilot study. J Neurosurg Spine. 2017;26(1):28–38.

    Article  PubMed  Google Scholar 

  38. Soroceanu A, Ching A, Abdu W, McGuire K. Relationship between preoperative expectations, satisfaction, and functional outcomes in patients undergoing lumbar and cervical spine surgery: a multicenter study. Spine (Phila Pa 1976). 2012;37:E103–8.

    Google Scholar 

  39. Milhorat TH, Nishikawa M, Kula RW, Dlugacz YD. Mechanisms of cerebellar tonsil herniation in patients with Chiari malformations as guide to clinical management. Acta Neurochir. 2010;152:1117–27.

    Article  PubMed  Google Scholar 

  40. Khan AA, Bhatti SN, Khan G, Ahmed E, Aurangzeb A, Ali A, et al. Clinical and radiological findings in Arnold Chiari malformation. J Ayub Med Coll Abbottabad. 2010;22:75–8.

    PubMed  Google Scholar 

  41. Mueller DM, Oro’ JJ. Prospective analysis of presenting symptoms among 265 patients with radiographic evidence of Chiari malformation type I with or without syringomyelia. J Am Acad Nurse Pract. 2004;16:134–8.

    Article  PubMed  Google Scholar 

  42. Noudel R, Gomis P, Sotoares G, Bazin A, Pierot L, Pruvo JP, et al. Posterior fossa volume increase after surgery for Chiari malformation Type I: a quantitative assessment using magnetic resonance imaging and correlations with the treatment response. J Neurosurg. 2011;115:647–58.

    Article  PubMed  Google Scholar 

  43. Alperin N, Loftus JR, Oliu CJ, Bagci A, Lee SH, Ertl-Wagner B, et al. Magnetic resonance imaging measures of posterior cranial fossa morphology and cerebrospinal fluid physiology in Chiari malformation type I. Neurosurgery. 2014;75:515–22.

    Article  PubMed  Google Scholar 

  44. Sekula RF Jr, Jannetta PJ, Casey KF, Marchan EM, Sekula LK, McCrady CS. Dimensions of the posterior fossa in patients symptomatic for Chiari I malformation but without cerebellar tonsillar descent. Cerebrospinal Fluid Res. 2005;2:11.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Urbizu A, Poca MA, Vidal X, Rovira A, Sahuquillo J, Macaya A. MRI-based morphometric analysis of posterior cranial fossa in the diagnosis of Chiari malformation type I. J Neuroimaging. 2014;24:250–6.

    Article  PubMed  Google Scholar 

  46. Strahle J, Muraszko KM, Kapurch J, Bapuraj JR, Garton HJ, Maher CO. Chiari malformation type I and syrinx in children undergoing magnetic resonance imaging. J Neurosurg Pediatr. 2011;8:205–13.

    Article  PubMed  Google Scholar 

  47. Sgouros S, Kountouri M, Natarajan K. Posterior fossa volume in children with Chiari malformation type I. J Neurosurg. 2006;105:101–6.

    PubMed  Google Scholar 

  48. Halvorson KG, Kellogg RT, Keachie KN, Grant GA, Muh CR, Waldau B. Morphometric analysis of predictors of cervical Syrinx formation in the setting of Chiari I malformation. Pediatr Neurosurg. 2016;51(3):137–41.

    Article  PubMed  Google Scholar 

  49. Gad KA, Yousem DM. Syringohydromyelia in patients with Chiari I malformation: a retrospective analysis. AJNR Am J Neuroradiol. 2017;38(9):1833–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Fenoy AJ, Menezes AH, Fenoy KA. Craniocervical junction fusions in patients with hindbrain herniation and syringohydromyelia. J Neurosurg Spine. 2008;9:1–9.

    Article  PubMed  Google Scholar 

  51. Grabb PA, Mapstone TB, Oakes WJ. Ventral brain stem compression in pediatric and young adult patients with Chiari I malformations. Neurosurgery. 1999;44:520–8.

    Article  CAS  PubMed  Google Scholar 

  52. Milhorat TH, Bolognese PA, Nishikawa M, McDonnell NB, Francomano CA. Syndrome of occipitoatlantoaxial hypermobility, cranial settling, and Chiari malformation Type I in patients with hereditary disorders of connective tissue. J Neurosurg Spine. 2007;7:601–9.

    Article  PubMed  Google Scholar 

  53. Brockmeyer DL. The complex Chiari: issues and management strategies. Neurol Sci. 2011;32(Suppl 3):S345–7.

    Article  PubMed  Google Scholar 

  54. Bollo RJ, Riva-Cambrin J, Brockmeyer MM, Brockmeyer DL. Complex Chiari malformations in children: an analysis of preoperative risk factors for occipitocervical fusion. J Neurosurg Pediatr. 2012;10(2):134–41.

    Article  PubMed  Google Scholar 

  55. Arora P, Behari S, Banerji D, Chhabra DK, Jain VK. Factors influencing the outcome in symptomatic Chiari I malformation. Neurol India. 2004;52(4):470–4.

    PubMed  Google Scholar 

  56. Kumar A, Pruthi N, Devi BI, Gupta AK. Morphometric factors affecting functional outcome in symptomatic Chiari I malformation and Syrinx. J Spinal Surg. 2017;4(4):145–9.

    Article  Google Scholar 

  57. Aghakhani N, Parker F, David P, Morar S, Lacroix C, Benoudiba F, et al. Long-term follow-up of Chiari-related syringomyelia in adults: analysis of 157 surgically treated cases. Neurosurgery. 2009;64:308–15.

    Article  PubMed  Google Scholar 

  58. Liu H, Yang C, Yang J, Xu Y. Pediatric Chiari malformation type I: long-term outcomes following small-bone-window posterior fossa decompression with autologous-fascia duraplasty. Exp Ther Med. 2017;14(6):5652–8.

    PubMed  PubMed Central  Google Scholar 

  59. Elster AD, Chen MY. Chiari I malformations: clinical and radiologic reappraisal. Radiology. 1992;183:347–53.

    Article  CAS  PubMed  Google Scholar 

  60. Nohria V, Oakes WJ. Chiari headaches. Neurology. 1993;43:1272.

    Article  CAS  PubMed  Google Scholar 

  61. Grangeon L, Puy L, Gilard V, Hebant B, Langlois O, Derrey S, et al. Predictive factors of headache resolution after Chiari type 1 malformation surgery. World Neurosurg. 2018;110:e60–6.

    Article  PubMed  Google Scholar 

  62. Armonda RA, Citrin CM, Foley KT, Ellenbogen RG. Quantitative cine-mode magnetic resonance imaging of Chiari I malformations: an analysis of cerebrospinal fluid dynamics. Neurosurgery. 1994;35:214–23.

    Article  CAS  PubMed  Google Scholar 

  63. Bhadelia RA, Bogdan AR, Wolpert SM, Lev S, Appignani BA, Heilman CB. Cerebrospinal fluid flow waveforms: analysis in patients with Chiari I malformation by means of gated phase-contrast MR imaging velocity measurements. Radiology. 1995;196:195–202.

    Article  CAS  PubMed  Google Scholar 

  64. Curless RG, Quencer RM, Katz DA, Campanioni M. Magnetic resonance demonstration of intracranial CSF flow in children. Neurology. 1992;42:377–81.

    Article  CAS  PubMed  Google Scholar 

  65. Oldfield EH, Muraszko K, Shawker TH, Patronas NJ. Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils. Implications for diagnosis and treatment. J Neurosurg. 1994;80:3–15.

    Article  CAS  PubMed  Google Scholar 

  66. Pujol J, Roig C, Capdevila A, Pou A, Marti-Vilalta JL, Kulisevsky J, et al. Motion of the cerebellar tonsils in Chiari type I malformation studied by cine phase-contrast MRI. Neurology. 1995;45:1746–53.

    Article  CAS  PubMed  Google Scholar 

  67. Wolpert SM, Bhadelia RA, Bogdan AR, Cohen AR. Chiari I malformations: assessment with phase-contrast velocity MR. AJNR Am J Neuroradiol. 1994;15:1299–308.

    CAS  PubMed  PubMed Central  Google Scholar 

  68. Arora P, Pradhan PK, Behari S, Banerji D, Das BK, Chhabra DK, et al. Chiari I malformation related syringomyelia: radionuclide cisternography as a predictor of outcome. Acta Neurochir. 2004;146(2):119–30.

    Article  CAS  PubMed  Google Scholar 

  69. McGirt MJ, Atiba A, Attenello FJ, Wasserman BA, Datoo G, Gathinji M, et al. Correlation of hindbrain CSF flow and outcome after surgical decompression for Chiari I malformation. Childs Nerv Syst. 2008;24(7):833–40.

    Article  PubMed  Google Scholar 

  70. Wang CS, Wang X, Fu CH, Wei LQ, Zhou DQ, Lin JK. Analysis of cerebrospinal fluid flow dynamics and morphology in Chiari I malformation with cine phase-contrast magnetic resonance imaging. Acta Neurochir. 2014;156(4):707–13.

    Article  PubMed  Google Scholar 

  71. Sakas DE, Korfias SI, Wayte SC, Beale DJ, Papapetrou KP, Stranjalis GS, et al. Chiari malformation: CSF flow dynamics in the craniocervical junction and syrinx. Acta Neurochir. 2005;147(12):1223–33.

    Article  CAS  PubMed  Google Scholar 

  72. Park CH, Chung TS, Kim DJ, Suh SH, Chung WS, Cho YE. Evaluation of intrasyrinx fluid motion by spatial modulation of magnetization-magnetic resonance imaging in syringomyelia with long-term follow-up: a predictor of postoperative prognosis? J Comput Assist Tomogr. 2008;32(1):135–40.

    Article  CAS  PubMed  Google Scholar 

  73. Alperin N, Sivaramakrishnan A, Lichtor T. Magnetic resonance imaging-based measurements of cerebrospinal fluid and blood flow as indicators of intracranial compliance in patients with Chiari malformation. J Neurosurg. 2005;103:46–52.

    Article  PubMed  Google Scholar 

  74. Alperin NJ, Lee SH, Loth F, Raksin PB, Lichtor T. MR-intracranial pressure (ICP): a method to measure intracranial elastance and pressure noninvasively by means of MR imaging: baboon and human study. Radiology. 2000;217:877–85.

    Article  CAS  PubMed  Google Scholar 

  75. Zhu Z, Wu T, Zhou S, Sun X, Yan H, Sha S, Qiu Y. Prediction of curve progression after posterior Fossa decompression in pediatric patients with scoliosis secondary to Chiari malformation. Spine Deform. 2013;1(1):25–32.

    Article  PubMed  Google Scholar 

  76. Mackel CE, Cahill PJ, Roguski M, Samdani AF, Sugrue PA, Kawakami N, et al. Factors associated with spinal fusion after posterior fossa decompression in pediatric patients with Chiari I malformation and scoliosis. J Neurosurg Pediatr. 2016;25(6):737–43.

    Google Scholar 

  77. Monk SH, Zhao S, Strahle J, Averill C, Couture DE, Johnston JM, et al. Predictors of spinal fusion within 2 years of posterior Fossa decompression in patients with Chiari malformation type 1 and scoliosis: a multi-institutional experience with the Park-Reeves Syringomyelia research consortium. Neurosurgery. 2018;65(Suppl 1):116–7.

    Article  Google Scholar 

  78. Ravindra VM, Onwuzulike K, Heller RS, Quigley R, Smith J, Dailey AT, et al. Chiari-related scoliosis: a single-center experience with long-term radiographic follow-up and relationship to deformity correction. J Neurosurg Pediatr. 2018;21(2):185–9.

    Google Scholar 

  79. Guan J, Riva-Cambrin J, Brockmeyer DL. Chiari-related hydrocephalus: assessment of clinical risk factors in a cohort of 297 consecutive patients. Neurosurg Focus. 2016;41(5):E2.

    Article  PubMed  Google Scholar 

  80. Zakaria R, Kandasamy J, Khan Y, Jenkinson MD, Hall SR, Brodbelt A, et al. Raised intracranial pressure and hydrocephalus following hindbrain decompression for Chiari I malformation: a case series and review of the literature. Br J Neurosurg. 2012;26:476–81.

    Article  PubMed  Google Scholar 

  81. Menger R, Connor DE Jr, Hefner M, Caldito G, Nanda A. Pseudomeningocele formation following Chiari decompression: 19-year retrospective review of predisposing and prognostic factors. Surg Neurol Int. 2015;6:70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Rieder E, Steinacher-Nigisch A, Weigel G. Human immune-cell response towards diverse xenogeneic and allogeneic decellularized biomaterials. Int J Surg. 2016;36:347–51.

    Article  PubMed  Google Scholar 

  83. Xu H, Wan H, Sandor M, Qi S, Ervin F, Harper JR, et al. Host response to human acellular dermal matrix transplantation in a primate model of abdominal wall repair. Tissue Eng Part A. 2008;14:2009–19.

    Article  CAS  PubMed  Google Scholar 

  84. Aliaga L, Hekman KE, Yassari R, Straus D, Luther G, Chen J, et al. A novel scoring system for assessing Chiari malformation type I treatment outcomes. Neurosurgery. 2012;70(3):656–64.

    Article  PubMed  Google Scholar 

  85. Thakar S, Sivaraju L, Jacob KS, Arun AA, Aryan S, Mohan D, et al. A points-based algorithm for prognosticating clinical outcome of Chiari malformation Type I with syringomyelia: results from a predictive model analysis of 82 surgically managed adult patients. J Neurosurg Spine. 2018;28(1):23–32.

    Article  PubMed  Google Scholar 

  86. Milhorat TH, Johnson RW, Milhorat RH, Capocelli AL Jr, Pevsner PH. Clinicopathological correlations in syringomyelia using axial magnetic resonance imaging. Neurosurgery. 1995;37:206–13.

    Article  CAS  PubMed  Google Scholar 

  87. Besachio DA, Khaleel Z, Shah LM. Odontoid process inclination in normal adults and in an adult population with Chiari malformation Type I. J Neurosurg Spine. 2015;23:701–6.

    Article  PubMed  Google Scholar 

  88. Tubbs RS, Wellons JC III, Blount JP, Grabb PA, Oakes WJ. Inclination of the odontoid process in the pediatric Chiari I malformation. J Neurosurg. 2003;98(1 Suppl):43–9.

    PubMed  Google Scholar 

  89. Smoker WR, Khanna G. Imaging the craniocervical junction. Childs Nerv Syst. 2008;24:1123–45.

    Article  PubMed  Google Scholar 

  90. Hyun SJ, Moon KY, Kwon JW, Lee CH, Kim J, Kim KJ, et al. Chiari I malformation associated with syringomyelia: can foramen magnum decompression lead to restore cervical alignment? Eur Spine J. 2013;22:2520–5.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Hirano M, Haughton V, Munoz del Rio A. Tapering of the cervical spinal canal in patients with Chiari I malformations. AJNR Am J Neuroradiol. 2012;33:1326–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  92. Furtado SV, Reddy K, Hegde AS. Posterior fossa morphometry in symptomatic pediatric and adult Chiari I malformation. J Clin Neurosci. 2009;16:1449–54.

    Article  PubMed  Google Scholar 

  93. Xie D, Qiu Y, Sha S, Liu Z, Jiang L, Yan H, et al. Syrinx resolution is correlated with the upward shifting of cerebellar tonsil following posterior fossa decompression in pediatric patients with Chiari malformation type I. Eur Spine J. 2015;24:155–61.

    Article  PubMed  Google Scholar 

  94. Jin J, Zhou S, Xu Q, An J. Identification of risk factors in epidemiologic study based on ROC curve and network. Sci Rep. 2017;7:46655.

    Article  PubMed  PubMed Central  Google Scholar 

  95. Hui L, Xiaoyi L, Murali R, Aidong Z. Prediction and informative risk factor selection of bone diseases. IEEE/ACM Trans Comput Biol Bioinform. 2015;12(1):79–91.

    Article  Google Scholar 

  96. Maaten LV, Hinton G. Visualizing data using t-SNE. J Mach Learn Res. 2008;9:2579–605.

    Google Scholar 

  97. Chawla NV, Bowyer KW, Hall LO, Kegelmeyer WP. SMOTE: synthetic minority over-sampling technique. J Artif Intell Res. 2002;16:321–57.

    Article  Google Scholar 

  98. Tan PN, Kumar V. Introduction to data mining. India: Doring Kindersely Pvt Ltd, Pearson Education; 2013.

    Google Scholar 

  99. Svetnik V, Liaw A, Tong C, Culberson JC, Sheridan RP, Feuston BP. Random forest: a classification and regression tool for compound classification and QSAR modeling. J Chem Inf Comput Sci. 2003;43(6):1947–58.

    Article  CAS  PubMed  Google Scholar 

  100. Chen T, Guestrin C. Xgboost. A scalable tree boosting system. In Proceedings of the 22nd ACM Sigkdd international conference on knowledge discovery and data mining. 2016. p. 785–94. ACM.

    Google Scholar 

  101. Kim IK, Wang KC, Kim IO, Cho BK. Chiari 1.5 malformation: an advanced form of Chiari I malformation. J Korean Neurosurg Soc. 2010;48:375–9.

    Google Scholar 

  102. Nishikawa M, Sakamoto H, Hakuba A, Nakanishi N, Inoue Y. Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa. J Neurosurg. 1997;86(1):40–7.

    Article  CAS  PubMed  Google Scholar 

  103. Khalsa SSS, Siu A, DeFreitas TA, Cappuzzo JM, Myseros JS, Magge SN, et al. Comparison of posterior fossa volumes and clinical outcomes after decompression of Chiari malformation Type I. J Neurosurg Pediatr. 2017;19(5):511–7.

    Article  PubMed  Google Scholar 

  104. Hammersley J, Haughton V, Wang Y, del Rio AM. Tapering of the cervical spinal canal in patients with scoliosis with and without the Chiari I malformation. AJNR Am J Neuroradiol. 2012;33:1752–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  105. Zhu Z, Sha S, Sun X, Liu Z, Yan H, Zhu W, et al. Tapering of the cervical spinal canal in patients with distended or nondistended syringes secondary to Chiari type I malformation. AJNR Am J Neuroradiol. 2014;35:2021–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  106. Thakar S, Kurudi Siddappa A, Aryan S, Mohan D, Sai Kiran NA, Hegde AS. Does the mesodermal derangement in Chiari Type I malformation extend to the cervical spine? Evidence from an analytical morphometric study on cervical paraspinal muscles. J Neurosurg Spine. 2017;27(4):421–7.

    Article  PubMed  Google Scholar 

  107. Wang X, Gao J, Wang T, Li Z, Li Y. Clinical significance of variable clivus gradients in patients with Chiari malformation Type I after surgical decompression: a retrospective analysis. World Neurosurg. 2018;S1878–8750(18):32365–9.

    Google Scholar 

  108. Henderson FC Sr, Henderson FC Jr, Wilson WA 4th, Mark AS, Koby M. Utility of the clivo-axial angle in assessing brainstem deformity: pilot study and literature review. Neurosurg Rev. 2018;41(1):149–63.

    Article  PubMed  Google Scholar 

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Acknowledgments

Source of Support: The authors have not received any support, in the form of grant, from any source for preparation of this chapter. Neither do the authors nor do their institutes have any personal or institutional financial interest in the contents of this submission.

Disclosure: There is no conflict of interest arising from this article.

Parts of this chapter have been published before in Thakar et al. [85]. Permission for reproducing material has been obtained from the Journal of Neurosurgery Publishing Group, AANS.

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Thakar, S., Aryan, S., Mani, S., Sarma, R.R. (2020). Predictive Analysis in Chiari Malformation Type I. In: Tubbs, R., Turgut, M., Oakes, W. (eds) The Chiari Malformations. Springer, Cham. https://doi.org/10.1007/978-3-030-44862-2_48

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