• de Oliveira RibeiroElayne CristinaECPostgraduate Program in Biological Sciences of the Federal University of Pernambuco, Recife, Brazil; Center of Medical Sciences of the Federal University of Paraíba, João Pessoa, Brazil., de BarrosDaniel Pereira MaurícioDPMCenter of Medical Sciences of the Federal University of Paraíba, João Pessoa, Brazil., do NascimentoJosé Jailson CostaJJCDepartament of Anatomy of the Federal University of Pernambuco, Recife, Brazil; Center of Medical Sciences of the Federal University of Paraíba, João Pessoa, Brazil. Electronic address: josejailson64@gmail.com., da Silva NetoEulâmpio JoséEJCenter of Medical Sciences of the Federal University of Paraíba, João Pessoa, Brazil., de Araújo NetoSeverino AiresSACenter of Medical Sciences of the Federal University of Paraíba, João Pessoa, Brazil., and Marcelo Moraes Valença.
• Postgraduate Program in Biological Sciences of the Federal University of Pernambuco, Recife, Brazil; Center of Medical Sciences of the Federal University of Paraíba, João Pessoa, Brazil.
• World Neurosurg. 2023 Oct 1; 178: e750e757e750-e757.

ObjectiveTo analyze the anatomical changes of the IV ventricle and cisterna magna in the Chiari malformation I (CMI) and basilar invagination (type B).MethodsThis is a controlled study with 161 exams of magnetic resonance imaging (MRI) of adults grouped into control (n = 37), basilar invagination (BI; n = 31), Chiari malformation I (CMI; n = 37), and CMI+BI (n = 56). The MRIs were analyzed using the visualization software Osirix (Pixmeo, Bernex, Geneva, version 3.8.2). The morphometric variables were: distance from the obex to the McRae line; length of the IV ventricle floor; and the area and volume of the cisterna magna. The univariate ANOVA followed by Tukey's post-hoc test was applied to evaluate the difference between the groups. The difference between sexes was evaluated by the t test for each group.ResultsAlterations in the cisterna magna and IV ventricle were more evident only in the CMI and CMI+BI groups. For both sexes, the CMI and CMI+BI groups showed: a reduction in the CSF space (P < 0.001), cisterna magna with volume reduction (P < 0.001), low position of the obex (P < 0.001), and IV ventricle more elongated (male P = 0.007 and female P < 0.001). The BI group had no significant change in the analysis by sex.ConclusionsThe CMI (isolated and associated with BI) showed a low obex position and elongation of the IV ventricle due to traction towards the spinal canal. The reduction of cisterna magna volume added to the occupation of the cerebellar tonsils can impact in the cerebrospinal fluid dynamics. The BI when isolated was not related to alterations in the parameters of cerebrospinal fluid spaces studied.Copyright © 2023 Elsevier Inc. All rights reserved.

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