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The purpose of this study is to decide which position of the neck affects cerebral spinal fluid (CSF) flow between the spinal cord and the brain. CSF is a fluid that flows up and down your spinal cord, around the brain and into the ventricles of the brain.
This study will be done with patients who have abnormalities of the neck, including Chiari 1 malformations.
In this study, subjects will have a dynamic cervical magnetic resonance imaging (MRI) of the craniovertebral junction (CVJ) coupled with CSF flow studies. The studies will assess changes in CSF flow velocities that are associated with with changing position of the neck at the CVJ and aqueduct of Sylvius.
Eligible patients include those with Chiari 1 malformations and similar malformations to the CVJ. This malformation lead to inherent instability in this region and symptoms such as headaches, dizziness, neck pain and other neurological problems. This study will determine if there is any correlation of these MRI findings to clinical outcome.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Normal volunteers who do not have malformations in their cerebral spinal fluid (CSF) |
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| 2 | Patients with incidentally discovered Chiari 1 DVS malformation of the cerebral spinal fluid (CSF) |
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| 3 | Patients with known Chiari or any other CVJ malformations undergoing a workup prior to surgery. Research images will be added to the clinically ordered exams ordered at 3 months and 1 year after surgery. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dynamic cervical MRI scans | Procedure | Serial MRI examination with the neck in flexion and extension to document changes in the cord compression and cerebral spinal fluid (CSF) |
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| Measure | Description | Time Frame |
|---|---|---|
| To compare changes in flow velocities at the CVJ (cranial vertebral junction) and aqueduct of Sylvius w/dynamic imaging in normal controls and in patients with symptomatic and asymptomatic Chiari 1 malformations and similar anomalies. | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Results from the primary outcome will be correlated with post operative changes in a subset of patients as a predictor for surgical outcomes. | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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Pilot group consisting of 10 healthy volunteers. Patients recruited w/incidental findings of Chiari 1 malformations and Patients recruited with known Chiari and other CVJ malformations (prior to surgery)
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| Name | Affiliation | Role |
|---|---|---|
| Rajiv Bapuraj, M.D., MD | University of Michigan | Principal Investigator |
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| ID | Term |
|---|---|
| D001139 | Arnold-Chiari Malformation |
| ID | Term |
|---|---|
| D009436 | Neural Tube Defects |
| D009421 | Nervous System Malformations |
| D009422 | Nervous System Diseases |
| D000013 | Congenital Abnormalities |
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| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |