Combining CSF hydrodynamics and 4th ventricle outlet morphology improves predictive performance of decompression for CM-I patients

Foramen magnum decompression (FMD) is the most used surgical treatment for Chiari malformation type I patients. However, 25～33% of them have persistent symptoms after surgery. This study aimed at investigating the possibility to predict the FMD outcome by using cerebral fluid (CSF) hydrodynamics and 4th ventricle outlet morphology obtained from magnetic resonance imaging. 27 patients were included and 17 of them had improved outcomes after FMD. Our results showed the peak diastolic velocity of CSF in aqueduct and the width of 4th ventricle outlet were associated with the FMD outcome and combining them can improve the prediction performance.