Chiari Malformation Research Articles

Coronavirus disease 2019-associated persistent cough and Chiari malformation type I resulting in acute respiratory failure: illustrative case.

Chiari malformation type I (CM-I) is the herniation of cerebellar tonsils through the foramen magnum, potentially resulting in the obstruction of cerebrospinal fluid flow and brainstem compression. Sleep-disordered breathing (SDB) is common in patients with CM-I, and symptomatic exacerbations have been described after Valsalva-inducing stressors. Acute decompensation in the setting of coronavirus disease 2019 (COVID-19) has not been described. After violent coughing episodes associated with COVID-19 infection, a 44-year-old female developed several months of Valsalva-induced occipital headaches, episodic bulbar symptoms, and worsening SDB, which led to acute respiratory failure requiring mechanical ventilation. Imaging demonstrated 12 mm of cerebellar tonsillar descent below the foramen magnum, dorsal brainstem compression, and syringobulbia within the dorsal medulla. She underwent posterior fossa and intradural decompression with near-complete resolution of her symptoms 6 months postoperatively. Although CM-I can remain asymptomatic, Valsalva-inducing stressors, including COVID-19 infection, can initiate or acutely exacerbate symptoms, placing patients at risk for CM-I-associated brainstem dysfunction and, in rare cases, acute respiratory failure. Worsening Valsalva maneuvers can contribute to further cerebellar tonsil impaction, brainstem compression, syringomyelia/syringobulbia, and worsening CM-I intradural pathology. Ventilator support and timely decompressive surgery are paramount, as brainstem compression can reduce central respiratory drive, placing patients at risk for coma, neurological deficits, and/or death.

Neuropsychological diagnosis of a female patient with Arnold-Chiari malformation type I

Arnold–Chiari I malformation is a congenital malformation of the hindbrain characterized by displacement of the cerebellar tonsils into the foramen magnum, pressure on the fourth ventricle, and decreased fluid flow to the basal cisterns. It is a mild form of the neuro-cranio-vertebral syndrome (Arnold–Chiari syndrome) because in many cases it is asymptomatic or has few clinical signs and symptoms of mild severity.The case study presented in the article concerns a 16.5-year-old patient with Arnold–Chiari I malformation following surgery. Based on the neuropsychological diagnosis, clinical symptoms that might result from the course of structural and functional changes in the hindbrain in Arnold–Chiari I syndrome were described and explained. The following were observed: selective difficulties in planning and concentration (maintaining the direction of action) and a weakening of visual perception (described by the patient as a subjective state of derealization).The results of the neuropsychological diagnosis point to certain practical implications for the further therapeutic treatment of patients with a mild form of Arnold–Chiari I malformation, especially as there is a risk of clinical symptoms changing over time due to the posibility of progressive neurodegenerative changes in the hindbrain.

Arnold-Chiari Malformation Presented with Spontaneous Down-Beating Nystagmus and Gait Disturbance

Arnold Chiari malformation is a disease which is characterized by herniation of a portion of the cerebellum through the foramen magnum. Symptoms vary depending on the extent of the affected area, including posterior neck pain, upper limb pain, paralysis, paresthesia, weakness, dizziness, and ataxia. Among the patients presenting with dizziness, nystagmus is frequently observed, which is primarily characterized by down-beating nystagmus. We experienced a 42- years-old female patient presented with vertigo and gait disturbance, who were diagnosed with type 1 Arnold-Chiari malformation and treated by surgical decompression.

Brain imaging abnormalities in children with dysphagia with aspiration: A retrospective study.

Head imaging is often performed in children with persistent dysphagia with aspiration to evaluate for Chiari malformations that may be associated with dysphagia. Unfortunately, the frequency of Chiari malformations or other head imaging abnormalities in children who aspirate is unknown. The goal of this study is to determine the frequency of head imaging abnormalities in children with evidence of aspiration or penetration on video fluoroscopic swallow study (VFSS). Tertiary Children's Hospital. We performed retrospective analysis of children with a diagnosis of aspiration evaluated at our center from January 2010 through April 2021. In this study, we included children with VFSS confirmedaspiration or penetration, brain magnetic resonance imaging (MRI) performed at our center, and without known genetic, congenital craniofacial, or neurologic abnormalities. Of the 977 patients evaluated in our system during that time with a diagnosis of aspiration, 185 children met the inclusion criteria. Eight children were diagnosed with Chiari malformations (4.3%) and 94 head MRIs were abnormal (51.4%). There was no difference in VFSS findings (frequency of aspiration, penetration, penetration-aspiration score, or recommended thickness of liquid) in children with a Chiari malformation versus other abnormalities or normal brain imaging. The majority of other non-Chiari brain imaging abnormalities were nonspecific. There was no difference in VFSS findings in children with abnormal MRI findings versus normal MRI. Brain imaging abnormalities are common in children who aspirate. Intervenable lesions are rare. Further studies are required to determine patients that will most likely benefit from brain imaging.

Clinical significance of morphological and morphometrical analysis of foramen magnum

Introduction: The foramen magnum is a transitional zone between cranial cavity and spinal canal, and it is related with the very important neuro-vascular structures like vertebral arteries, spinal accessory nerves and spinal arteries and terminal part of medulla oblongata. Therefore, thorough knowledge of morphometric and morphological variation of foramen magnum is important for authentic radiological diagnosis and surgeries in the area of cranio-cervical junction. Materials and Methods: This study was done on 70 dried human skulls taken from the Department of Anatomy, TS Misra Medical College & Hospital, Era’s Lucknow Medical College & Hospital, and KGMU, Lucknow. The shape of foramen magnum was observed and transverse and antero-posterior (AP) diameters of foramen magnum (FM) were measured with the help of vernier caliper. Foramen magnum index (FMI) and foramen magnum area (FMA) were also calculated. Results: The study showed six types of shapes of foramen magnum. The oval shaped foramen magnum was found in 47% (in 33 skulls), round 30% (in 30 skulls), tetragonal 10 % (in 10 skulls), triangular & irregular 10% (in 5-5 skulls), pentagonal 2% (in 2 skulls), and hexagonal 1% (in single skull). The mean anteroposterior and transverse diameter were 34.3±2.90mm and 28.9±2.80 mm respectively. The mean foramen magnum index and Foramen magnum area were 77.80±27.80 and 845.90±87.50 mm2 respectively. Conclusions: The data obtained from the present study will be useful to the neurosurgeons prior to the surgeries in the area of cranio-cervical junction and posterior cranial fossa. The morphometric and morphological knowledge of the foramen Magnum has important clinical implications in the prognosis and treatment of various neurological pathologies like Arnold Chiari syndrome, Achondroplasia and posterior cranial fossa lesions. Keywords: Foramen magnum, Transcondylar approach, Foramen magnum index, Foramen magnum area, Transverse diameter (TD), Anteroposterior diameter, Trigonal.

Differentiated diagnostic and surgical algorithm for isolated and combined Chiari malformation Type I

Introduction: Arnold-Chiari malformation (ACM) type I is a craniovertebral junction pathology with ectopy of the cerebellar tonsils through the great occipital foramen with compression of the brain stem and upper cervical spinal cord. Until now, there have been more than 20 types of surgical interventions for the Arnold-Chiari malformation type. Objective: The main purpose of this research is the decompression of craniovertebral stem structures and occipital foramen, and the search for effective methods to repair cerebrospinal fluid (CSF) circulation. Methods: The complex examination and surgical treatment at the Neurosurgery Department No. 1 of the National Hospital of the Ministry of Health of the Kyrgyz Republic (Bishkek, Kyrgyzstan) passed 201 patients (aged 16-74) with symptomatic ACM I from 2008 to 2020.

A long-term follow-up study of adults with Chiari malformation type I combined with syringomyelia.

There is a considerable amount of controversy regarding the treatment and prognosis of adult patients with Chiari malformation type I (CM-I) at home and abroad; furthermore, no large-sample, long-term, follow-up studies have examined CM-I patients with syringomyelia (SM) comparing posterior fossa decompression with resection of tonsils (PFDRT) vs. posterior fossa decompression with duraplasty (PFDD). This study retrospectively analyzed the factors affecting the treatment and long-term prognosis of adults with CM-I combined with SM. We retrospectively analyzed data from 158 adult CM-I patients combined with SM who underwent PFDRT or PFDD, including 68 patients in group PFDRT and 90 patients in group PFDD. We examined the clinical manifestations, imaging features, and follow-up data of patients. Clinical outcomes were assessed using the Chicago Chiari Outcomes Scale (CCOS), and radiographic outcomes were indicated by the syrinx remission rate. Multivariate logistic regression analysis and multiple linear regression analysis were used to explore the relevant factors affecting the long-term prognosis of patients. This study showed that compared with preoperative patients in the PFDRT group and PFDD group, the sensory impairment, cough-related headache, and movement disorder were significantly improved (p < 0.01); meanwhile, the diameter of the syrinx and the volume of the syrinx decreased significantly (p < 0.001). Additionally, the study found that there were significant differences in the syrinx remission rate (p = 0.032) and the clinical cure rates (p = 0.003) between the two groups. Multivariate logistic regression analysis showed that age (p = 0.021), cerebellar-related symptoms (p = 0.044), preoperative cisterna magna volume (p = 0.043), and peak systolic velocity (p = 0.036) were independent factors for clinical outcomes. Multiple linear regression analysis showed that different surgical procedures were positively correlated with the syrinx remission rate (p = 0.014), while preoperative syrinx diameter (p = 0.018) and age (p = 0.002) were negatively correlated with the syrinx remission rate. In conclusion, this study suggested that, in a long-term follow-up, although both surgical procedures are effective in treating patients with CM-I and SM, PFDRT is better than PFDD; age and cerebellar-related signs independently affect the patient's prognosis. Additionally, an effective prognosis evaluation index can be developed for patients, which is based on imaging characteristics, such as preoperative cisterna magna volume, preoperative syrinx diameter, and preoperative cerebrospinal fluid (CSF) hydrodynamic parameters to guide clinical work.

Human genetics and molecular genomics of Chiari malformation type 1.

Chiari malformation type 1 (CM1) is the most common structural brain disorder involving the pboard1 junction, characterized by caudal displacement of the cerebellar tonsils below the foramen magnum into the spinal canal. Despite the heterogeneity of CM1, its poorly understood patho-etiology has led to a 'one-size-fits-all' surgical approach, with predictably high rates of morbidity and treatment failure. In this review we present multiplex CM1 families, associated Mendelian syndromes, and candidate genes from recent whole exome sequencing (WES) and other genetic studies that suggest a significant genetic contribution from inherited and de novo germline variants impacting transcription regulation, craniovertebral osteogenesis, and embryonic developmental signaling. We suggest that more extensive WES may identify clinically relevant, genetically defined CM1 subtypes distinguished by unique neuroradiographic and neurophysiological endophenotypes.

Clinical Efficacy of Minimally Invasive Subpial Tonsillectomy (MIST) for Treatment of Chiari Malformation (Type I) with Syringomyelia

Objective: To investigate the clinical efficacy of minimally invasive subpial tonsillectomy (MIST) in the treatment of Chiari malformation (type I) with syringomyelia. Method A total of 209 Chiari malformation (type I) patients with syringomyelia were studied. The patients were grouped based on the syrinx diameter changes: complete disappearance group (48 patients), obvious shrinkage group (147 patients), and non-obvious shrinkage group (14 patients). The Chicago Chiari Outcome Scale (CCOS) was used to compare clinical data of the three groups of patients before treatment. The correlations between disease duration and syrinx diameter changes as well as post-treatment clinical symptoms were analyzed. The related factors of efficacy were analyzed. Results: Age and disease duration were the oldest/longest in the non-obvious shrinkage group, and the youngest/shortest in the complete disappearance group (P &lt; 0.05). The maximum diameter reduction of syrinx was the greatest in the complete disappearance group, and the smallest in the non-obvious shrinkage group ( P &lt; 0.05). The proportions of patients with hypoesthesia, limb weakness, and muscle atrophy were the largest in the non-obvious shrinkage group, and the smallest in the complete disappearance group ( P &lt; 0.05). The CCOS score were the highest in the complete disappearance group, and the lowest in the non-obvious shrinkage group ( P &lt; 0.05). There were statistically significant (P &lt; 0.05) negative correlations between disease duration and maximum diameter reduction of syrinx, CCOS pain score, CCOS non-pain score, CCOS functionality score, and CCOS complication score, disease duration and hypoesthesia, limb weakness, muscle atrophy, and sleep apnea. Result of multivariate stepwise regression analysis indicated that age, disease duration, and preoperative syrinx diameter were the risk factors for efficacy (P &lt; 0.05). Conclusion: For patients with Chiari malformation complicated by syringomyelia, the longer the disease duration, the more difficult it is to achieve syrinx reduction and improve the clinical symptoms. “Minimally invasive subpial tonsillectomy (MIST) and cisterna magna reconstruction” is an improved surgical approach to treat Chiari malformation (cerebellar tonsil herniation). It has the advantages of small incision, less postoperative reaction, and fewer complications, and it emphasizes the reshaping and repair of cerebellar tonsils, reconstruction of cisterna magna, and restoration of cerebrospinal fluid circulation.

A case report of Arnold-Chiari malformation type one associated with syringomyelia, syringobulbia and migraine in a 34-years-old Sudanese female

A case report of Arnold-Chiari malformation type one associated with syringomyelia, syringobulbia and migraine in a 34-years-old Sudanese female

HHV-6 meningitis with delayed diagnosis due to Chiari malformation in an immunocompetent adult: A case report and literature review

HHV-6 meningitis with delayed diagnosis due to Chiari malformation in an immunocompetent adult: A case report and literature review

Decoding Chiari Malformation and Syringomyelia: From Epidemiology and Genetics to Advanced Diagnosis and Management Strategies.

Chiari Malformation and Syringomyelia are neurosurgical entities that have been the subject of extensive research and clinical interest. Globally prevalent, these disorders vary demographically and have witnessed evolving temporal trends. Chiari Malformation impacts the normal cerebrospinal fluid flow, consequently affecting overall health. Key observations from canine studies offer pivotal insights into the pathogenesis of Syringomyelia and its extrapolation to human manifestations. Genetics plays a pivotal role; contemporary knowledge identifies specific genes, illuminating avenues for future exploration. Clinically, these disorders present distinct phenotypes. Diagnostically, while traditional methods have stood the test of time, innovative neurophysiological techniques are revolutionizing early detection and management. Neuroradiology, a cornerstone in diagnosis, follows defined criteria. Advanced imaging techniques are amplifying diagnostic precision. In therapeutic realms, surgery remains primary. For Chiari 1 Malformation, surgical outcomes vary based on the presence of Syringomyelia. Isolated Syringomyelia demands a unique surgical approach, the effectiveness of which is continually being optimized. Post-operative long-term prognosis and quality of life measures are crucial in assessing intervention success. In conclusion, this review amalgamates existing knowledge, paving the way for future research and enhanced clinical strategies in the management of Chiari Malformation and Syringomyelia.

CLINICAL AND NEUROLOGICAL FEATURES OF ISOLATED AND COMPLICATED CHIARI MALFORMATION TYPE I

The review article, based on the analysis of modern literature data, presents symptoms, syndromes and symptom complexes of isolated Chiari malformation type I (MCI) and in combination with syringomyelia, scoliosis, hydrocephalus. It was concluded that the possession of such information for outpatient and hospital health care doctors will allow them to suspect a malformation and continue diagnosis at the level of neuroimaging. The critical importance of a detailed neurological status of the patient in determining the indications for conservative treatment or surgical intervention, choosing the technique and extent of the operation is also emphasized.

Prenatal diagnosis and postnatal outcome of closed spinal dysraphism.

To evaluate the prenatal diagnosis of closed dysraphism (CD) and its correlation with postnatal findings and neonatal adverse outcomes. A retrospective cohort study including pregnancies diagsnosed with fetal CD by prenatal ultrasound (US) and magnetic resonance imaging (MRI) at a single tertiary center between September 2011 and July 2021. CD was diagnosed prenatally and confirmed postnatally in 12 fetuses. The mean gestational age of prenatal imaging was 24.2weeks, in 17% the head circumference was ≤fifth percentile and in 25% the cerebellar diameter was ≤fifth percentile. US findings included banana sign in 17%, and lemon sign in 33%. On MRI, posterior fossa anomalies were seen in 33% of cases, with hindbrain herniation below the foramen magnum in two cases. Mean clivus-supraocciput angle (CSA) was 74°. Additional anomalies outside the CNS were observed in 50%. Abnormal foot position was demonstrated prenatally in 17%. Neurogenic bladder was present in 90% of patients after birth. Arnold Chiari II malformation and impaired motor function can be present on prenatal imaging of fetuses with CD and may be associated with a specific type of CD. Prenatal distinction of CD can be challenging. Associated extra CNS anomalies are frequent and the rate of neurogenic urinary tract dysfunction is high.

Management of Persistent Syringomyelia in Patients Operated for Chiari Malformation Type 1

The treatment of persistent syringomyelia associated with Chiari malformation type 1 (CM1) is unclear. This study aims to evaluate the clinical and radiologic outcomes of syringo-subarachnoid shunt (SSS) as a treatment for persistent syringomyelia following posterior fossa decompression (PFD) for CM1. Forty-nine cases treated for CM1 associated syringomyelia at a single center were analyzed, 17 of them undergoing reoperation due to persistent syrinx formation. The patients' demographic data, neurologic presentations, and radiologic results were analyzed, including cerebellar herniation, posterior fossa volume, the level at which the syrinx started and finished, the size and diameter of the syrinx. Seventeen patients underwent SSS placement, with 1 minor surgical complication (a cerebrospinal fluid leak) occurring and requiring revision. No morbidity or mortality was observed. Among these 17 reoperated patients, partial or complete resorption of the syrinx was observed in all cases. The results suggest that if the syrinx diameter is >10 mm at its thickest point, extends for more than 10 vertebrae, and starts from the upper cervical region and extends to the upper thoracic region, the syrinx may not regress after the first surgery and potentially predicting the need for a second operation before PFD. SSS placement for persistent syrinx following PFD for CM1 is a safe and effective surgical treatment method. These criteria may also help predict the need for a second surgery and the overall disease outcome for both the surgeon and patient.

Non-invasive Intracranial Pressure Waveform Analysis in Chiari Malformation Type 1: A Pilot Trial

This pilot study aimed to investigate the role of Posterior Fossa Decompression (PFD) on the intracranial pressure (ICP) waveform in patients with Chiari Malformation type 1 (CM1). It also sought to explore the relationship between symptom improvement and ICP waveform behavior. This exploratory cohort study evaluated adult patients diagnosed with CM1. The patients underwent PFD using a standard technique at our institution, which involved a 3× 3 cm posterior craniectomy and excision of the posterior arch of C1. The ICP waveform was measured using an external strain-gauge device connected to a pin attached to the skull. Measurements were collected pre- and post-PFD, and the P2/P1 ratio was calculated pre- and postoperatively. The pilot study comprised 6 participants, 3 men and 3 women, with ages ranging from 39 to 68years. The primary symptoms were cerebellar ataxia and typical headaches. The study found that most patients who showed clinical improvement, as judged by the Gestalt method, had a postoperative decrease in the P2/P1 ratio. However, 1 patient did not show an improvement in the P2/P1 ratio despite a good clinical outcome. This study suggests that the P2/P1 ratio may decrease after PFD. However, we highlight the need for further research with a larger sample size to confirm these preliminary results.

Coexistence of Pseudotumor Cerebri and Chiari Malformation Type 1

Objective: To identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1. Method: Patients who were clinically suspected to have Chiari malformation type 1 and were referred to the Department of Radiology between 2007 and 2020, and whose diagnosis was radiologically confirmed through magnetic resonance imaging (MRI), were retrospectively evaluated. A total of 49 Chiari malformation type 1 patients with both cervical and cerebral examinations and 49 control subjects of the same age and gender without a diagnosis of Chiari malformation type 1 were included in the study. In Chiari malformation type 1 diagnosed patients, the presence of pseudotumor cerebri, the presence of syringomyelia in cervical spinal MRI images, and the distance of cerebellar tonsils and obex according to McRae line were evaluated in millimeters. Result: In Chiari malformation type 1 clinically and radiologically diagnosed cases, the cerebellar tonsils and obex were located lower in patients with a radiological diagnosis of pseudotumor cerebri compared to those without, and the rate of accompanying syringomyelia appeared to be higher. However, no statistically significant difference was observed between the two groups. Conclusion: The coexistence of pseudotumor cerebri and Chiari malformation type 1 is more common than previously estimated. Different treatment protocols in the coexistence of pseudotumor cerebri and Chiari malformation type 1 emphasize the importance of making this diagnosis. Further radiological imaging studies are needed to identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1.

From Text to Insight: A Natural Language Processing-Based Analysis of Topics and Trends in Neurosurgery.

Neurosurgical research is a rapidly evolving field, with new research topics emerging continually. To provide a clearer understanding of the evolving research landscape, our study aimed to identify and analyze the prevalent research topics and trends in Neurosurgery. We used BERTopic, an advanced natural language processing-based topic modeling approach, to analyze papers published in the journal Neurosurgery . Using this method, topics were identified based on unique sets of keywords that encapsulated the core themes of each article. Linear regression models were then trained on the topic probabilities to identify trends over time, allowing us to identify "hot" (growing in prominence) and "cold" (decreasing in prominence) topics. We also performed a focused analysis of the trends in the current decade. Our analysis led to the categorization of 12 438 documents into 49 distinct topics. The topics covered a wide range of themes, with the most commonly identified topics being "Spinal Neurosurgery" and "Treatment of Cerebral Ischemia." The hottest topics of the current decade were "Peripheral Nerve Surgery," "Unruptured Aneurysms," and "Endovascular Treatments" while the cold topics were "Chiari Malformations," "Thromboembolism Prophylaxis," and "Infections." Our study underscores the dynamic nature of neurosurgical research and the evolving focus of the field. The insights derived from the analysis can guide future research directions, inform policy decisions, and identify emerging areas of interest. The use of natural language processing in synthesizing and analyzing large volumes of academic literature demonstrates the potential of advanced analytical techniques in understanding the research landscape, paving the way for similar analyses across other medical disciplines.

Protracted respiratory failure in a case of global spinal syringomyelia and Chiari malformation following administration of diazepam: illustrative case.

Syringomyelia is defined as dilation of the spinal cord's central canal and is often precipitated by skull base herniation disorders. Although respiratory failure (RF) can be associated with skull base abnormalities due to brainstem compression, most cases occur in pediatric patients and quickly resolve. The authors report the case of an adult patient with global spinal syringomyelia and Chiari malformation who developed refractory RF after routine administration of diazepam. A 31-year-old female presented with malnutrition, a 1-month history of right-sided weakness, and normal respiratory dynamics. After administration of diazepam prior to magnetic resonance imaging (MRI), she suddenly developed hypercapnic RF followed MRI and required intubation. MRI disclosed a Chiari malformation type I and syrinx extending from C1 to the conus medullaris. After decompressive surgery, her respiratory function progressively returned to baseline status, although 22 months after initial benzodiazepine administration, the patient continues to require nocturnal ventilation. Administration of central nervous system depressants should be closely monitored in patients with extensive syrinx formation given the potential to exacerbate diminished central respiratory drive. Early identification of syrinx in the context of Chiari malformation and hemiplegia should prompt clinical suspicion of underlying respiratory compromise and early involvement of intensive care consultants.

Cerebrospinal Fluid Flow Parameters in Normal Subjects above 40 Years of Age

Abstract Background Cerebrospinal fluid (CSF) flow is altered in many conditions like normal pressure hydrocephalus (NPH), aqueduct stenosis, or Chiari malformation. It is very important to know the normal CSF flow parameters for properly diagnosing these conditions. No data on CSF flow parameters of the Indian population are available. Hence, this study was undertaken to generate normative CSF flow parameters in the Indian population. Aim Our aim was to estimate normal CSF flow parameters across the cerebral aqueduct in Indian subjects over 40 years of age. Settings and Design This observational study was done in the tertiary care institute on subjects undergoing magnetic resonance imaging (MRI) for indications like headache and having normal MRI. Methods Phase-contrast quantitative flow sequence was done in 100 subjects perpendicular to the cerebral aqueduct on 3.0T MRI (Discovery 750w with GEM suit, GE, Milwaukee, WI, United States) using a dedicated 32-channel head coil with 10 cm/s velocity encoding. The region of interest was kept at the cerebral aqueduct in cross-section. The inbuilt software calculated flow-time and velocity-time graphs and calculated peak systolic velocity (PSV), peak diastolic velocity (PDV), systolic flow (SF), and diastolic flow (DF). Stroke volume (SV) was calculated by averaging systolic and DFs. p-Value &lt; 0.05 was considered significant. Results Mean age was 53.72 ± 10.53 (40–78) years with 41 males and 59 females. PSV, PDV, SF, DF, and SV all showed a significant linear correlation with age with p-values of 0.001, 0.004, 0.009, &lt;0.001, and &lt;0.001, respectively. Only PDV (p = 0.035) and DF (p = 0.045) varied significantly with sex, values being higher in males. Conclusion All five CSF flow parameters studied vary positively with age, and this variation is linear. Normal decadal median values calculated for these parameters can act as baseline values for the local population and help in defining conditions like NPH.