The mean overall score was 14.0 over a mean follow-up of 27.2 months. Direct comparisons were made across the three age groups. Patient outcomes were assigned a numerical value based on the CCOS and statistically analyzed. To compare postoperative outcomes between different age groups using the Chicago Chiari Outcome Scale (CCOS).ДЎ44 patients who underwent Chiari decompression at our institution between 20 were divided into 3 groups, Group A (children ages 0-18 years), Group B (younger adults ages 19-40 years), and Group C (older adults ages 41 years and above). There is currently inadequate evidence on efficacy of surgical decompression for Chiari malformation type I (CM1) across different age groups. Areas for future research remain plentiful. The importance of diligent assessment and treatment of cognitive and affective dysfunction in CM1 patients is highlighted.

Aspects of CSF flow irregularities may play a role in the etiology of the neuropsychological profile of CM1 patients. Conclusion: CM1 patients demonstrate greater impairment on facets of executive function and greater global affective dysregulation than the normative population. Severity of tonsillar descent and CSF volume was not found to be predictive of any other executive or affective variable. Greater CSF volume was predictive of lower phonemic fluency performance. No significant differences were found on measures of inhibition, set-shifting, and semantic fluency. Results: CM1 patients scored significantly lower than the normative population on executive function tasks that measured phonemic fluency, perseveration, and abstract thinking and significantly higher on affective measures of anxiety, depression, and hostility. Methods: Demographic, neuropsychological, and neurological data was analyzed in 46 in pre-surgery CM1 patients. Objectives: The current study aims to 1) provide a profile of executive and affective functioning in pre-surgery CM1 patients 2) to determine if pre-surgery CM1 patients exhibit executive dysfunction and affective dysregulation when compared to a normative population and 3) to investigate the relative influence of CM1 clinical characteristics on executive dysfunction and affective dysregulation. The role of the cerebellum has been established as essential in cognitive and affective processes (Marek et al., 2018) Research examining cognition and affect in CM1 is severely lacking (Rogers et al., 2018). Introduction: Chiari Malformation Type 1 (CM1) is a structural brain abnormality characterized by the displacement of the cerebellar tonsils below the foramen magnum (Fernandez et al., 2009), most often leading to chronic headache (Fischbein et al., 2015). Patient and physician education about CM I may permit early intervention and the prevention of further deterioration and patient suffering. CM I can be a challenging condition for patients and physicians, during both the search for diagnosis and management of symptoms. Fear was the most frequent emotion elicited at the time of correct diagnosis (42.19 %). Common misdiagnoses were classified as psychological (19.26 %) and neurological (19.26 %). CM I diagnosis was found incidentally for 24.87 % of participants. Average time to diagnosis from first physician visit to diagnosis was 3.43 years, and only 8.46 % of patients had previous awareness of CM. Neurocognitive comorbidities included memory difficulties (43.88 %) and aphasia (43.75 %) and psychological disorders such as depression (31.77 %) and anxiety disorders (19.92 %) were reported. Pain was the most frequently reported symptom (76.69 %) experienced prior to diagnosis with headaches implicated most often (73.44 %). Participants were 768 individuals with CM I and were predominantly female (86.8 %) and Caucasian (93.8 %) with an average age of 35 years. Analyses included descriptive statistics to study body system impact and patient diagnostic experiences.

The current research is one component of a large investigation designed to collect information from individuals with CM through the online Conquer Chiari Patient Registry questionnaire. This study reports from the only national, online patient registry available, the symptoms, comorbid neurocognitive and psychological conditions, and diagnostic experiences of patients living with CM type I (CM I). Chiari malformation (CM) is a condition in which cerebellar tonsillar ectopia may manifest with various clinical presentations.

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