Cough-Associated Headache in Patients with Chiari I Malformation: CSF Flow Analysis by Means of Cine Phase-Contrast MR Imaging

• Published in: American journal of neuroradiology : AJNR Vol. 32; no. 4; pp. 739 - 742
• Main Authors: BHADELIA, R. A, FREDERICK, E, PATZ, S, DUBEY, P, ERBAY, S. H, DO-DAI, D, HEILMAN, C
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL American Society of Neuroradiology 01.04.2011
• Series: Clinical Report
• Subjects: Adolescent; Adult; Arnold-Chiari Malformation - complications; Arnold-Chiari Malformation - pathology; Arnold-Chiari Malformation - physiopathology; Biological and medical sciences; Blood Flow Velocity - physiology; Brain; Cardiovascular system; Cerebrovascular Circulation - physiology; Child; Child, Preschool; Female; Foramen Magnum; Headache Disorders, Primary - etiology; Headache Disorders, Primary - pathology; Headache Disorders, Primary - physiopathology; Humans; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging, Cine - methods; Male; Medical sciences; Middle Aged; Nervous system; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Young Adult; Human; Headache; Nervous system diseases; Radiodiagnosis; Cerebrospinal fluid; Congenital disease; Nuclear magnetic resonance imaging; Cough; Cerebral disorder; Pain; Arnold-Chiari malformation; Malformation; Phase contrast; Central nervous system disease; Neurological disorder
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A2369

The purpose of this study was to analyze the CSF flow in patients with Chiari I to determine differences between patients with and without CAH. Thirty patients with Chiari I malformation underwent cine-PC CSF flow imaging in the sagittal plane. CSF flow pulsations were analyzed by placing regions of interest in the anterior cervical subarachnoid space. Maximum CSF systolic (craniocaudal) and diastolic (caudocranial) velocities as well as the durations of CSF systole and diastole (measured in fractions of the cardiac cycle) were determined. In the region of interest just below the foramen magnum, patients with CAH had a significantly shorter CSF systole and longer diastole (P=.02). A CSF diastolic length of ≥0.75 of the cardiac cycle was 67% sensitive and 86% specific for CAH. Our results indicate that Cine-PC imaging can show differences in CSF flow patterns in patients with Chiari I with and without CAH.