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. 2023 Oct 1;93(4):723-726.
doi: 10.1227/neu.0000000000002633. Epub 2023 Aug 30.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Patients With Chiari Malformation: Diagnosis

David F Bauer  1   2 , Toba Niazi  3 , Rabia Qaiser  4 , Libby Kosnik Infinger  5 , Shobhan Vachhrajani  6 , Laurie L Ackerman  7 , Eric M Jackson  8 , Sarah Jernigan  9 , Cormac O Maher  10 , Jogi V Pattisapu  11 , Carolyn Quinsey  12 , Jeffrey S Raskin  13 , Brandon G Rocque  14 , Howard Silberstein  15
Affiliations

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Patients With Chiari Malformation: Diagnosis

David F Bauer et al. Neurosurgery. .

Abstract

Background: Chiari I malformation (CIM) is characterized by descent of the cerebellar tonsils through the foramen magnum, potentially causing symptoms from compression or obstruction of the flow of cerebrospinal fluid. Diagnosis and treatment of CIM is varied, and guidelines produced through systematic review may be helpful for clinicians.

Objective: To perform a systematic review of the medical literature to answer specific questions on the diagnosis and treatment of CIM.

Methods: PubMed and Embase were queried between 1946 and January 23, 2021, using the search strategies provided in Appendix I of the full guidelines.

Results: The literature search yielded 567 abstracts, of which 151 were selected for full-text review, 109 were then rejected for not meeting the inclusion criteria or for being off-topic, and 42 were included in this systematic review.

Conclusion: Three Grade C recommendations were made based on Level III evidence. The full guidelines can be seen online at https://www.cns.org/guidelines/browse-guidelines-detail/1-imaging .

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References

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    1. Milhorat TH, Bolognese PA, Nishikawa M, et al. Association of Chiari malformation type I and tethered cord syndrome: preliminary results of sectioning filum terminale. Surg Neurol. 2009;72(1):20-35.
    1. Leung V, Magnussen JS, Stoodley MA, Bilston LE. Cerebellar and hindbrain motion in Chiari malformation with and without syringomyelia. J Neurosurg Spine. 2016;24(4):546-555.
    1. Taylor DG, Chatrath A, Mastorakos P, et al. Cerebrospinal fluid area and syringogenesis in Chiari malformation type I. J Neurosurg. 2020;134(3):825-830.
    1. Ransohoff DF, PignoneSox MHC, Sox HC. How to decide whether a clinical practice guideline is trustworthy. JAMA. 2013;309(2):139-140.

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