0:00

That I'm, I'm gonna move to keary malformations, which are,

0:02

are more cranio cervical obstructions, um, and can result in hydrocephalus. So,

0:06

we'll, we'll talk about those and then we'll, we'll conclude and I'll,

0:09

I'll take a look at the questions and answers again and see if there's anything

0:11

that I can help people understand a little better or answer any more, you know,

0:15

um, philosophical questions if, if those arise. Um,

0:18

so keary malformations are congenital lesions that are usually associated with a

0:21

small posterior fossa type. Ones are the most common.

0:24

There's usually tons ectopia and the tonsor usually, um,

0:27

as they herniate through the frame of magnum take on like a peg like appearance.

0:30

And that doesn't always happen, but that's, that's what we're looking for,

0:33

sort of a peg like appearance. Um, is the classic qre twos are, um,

0:38

displacement of the cerebellar tonsils and the brain stem through the frame of

0:41

magnum with usually a lumbosacral pseudo or lumbosacral myelo meningocele.

0:46

And then type threes are similar to car twos with either a high cervical or

0:49

occipital myelo meningocele.

0:50

And they're typically associated with both hydrocephalus and, um, senal hydro,

0:55

um, imaging can demonstrate, um, crowding the frame of magnum again,

0:59

like with those p peg light, um, uh,

1:01

cerebellar tonsils that you can see a srin sometimes, um, low line conus,

1:06

especially with the Qre two. Um,

1:08

because of the mylo andous steel and the tethering of the cord. Um,

1:10

the ventricles can be enlarged in some cases if they,

1:13

if they have hydrocephalus. And you can also see, um,

1:15

decreased C S F flow around the frame of magnum and brainstem.

1:18

D ss F flow studies on m r I can be very helpful in determining which patients

1:22

are really symptomatic due to their qi and, and help guide surgical management.