Chiari & Syringomyelia Research Foundation Inc

Programs: 1. )column of hope has dedicated resources to improve chiari malformation & syringomyelia (cm/sm) patients' immediate treatment. Coh's prior funding prompted other funding to produce papers on surgical techniques. The first two of a series of articles were published in world neurosurgery in 2017. These dealt with treating cranio-cervical junction arachnoiditis (ccja) and techniques to improve subarachnoid shunt surgery outcomes. We anticipate 2017 funding will produce two more clinical papers; one on surgical and one on diagnostic technique. The clinical funding also produced comprehensive literature review on how cm impacts patients' cognition. This study attracted further funding to perform research in what outcome is required in cm surgery to improve patients' cognition. We hope future work will lead to required surgical outcomes to also improve the chiari headache, eliminate sm and the other major debilitating conditions suffered by cm/sm patients. (two 2017 publications and one in early 2018) 2. )our commitment to improved clinical outcomes was also demonstrated in 2017 by a cme program for western new york medical professionals and a cm/sm/eds patient information seminar.

1. The phd candidate has completed 24 models of chiari patients and controls based on our previous human mri scanning studies and linked them to our previous perivascular space model that calculates fluid flow into the spinal cord. This work was published in the journal of biomechanics in 2017. 2. The phd candidate is now doing pilot mri scans for the next phase of his project, which can measure csf flow during breathing. We hope to have this study running early next year. Respiratory gated cine mris are a key component of our future physiology of syrinx formation work. It is also be important for our emphasis on what clinical outcome from cm/sm surgery is required to produce actual improvement in patients. 3. The scholarship recipient is also continuing another modelling study. In the meantime, they are looking at how the cardiac pulse affects csf flow and syrinx formation.

expenditures also include funding for the following: four (4) new peer reviewed studies published in 2017 and early 2018. 1. The ultrastructure of spinal cord perivascular spaces: implications for the circulation of cerebrospinal fluid : nature - scientific reports 2. Sustained high-pressure in the spinal subarachnoid space while arterial expansion is low may be linked to syrinx development - computer methods in biomechanics and biomedical engineering 3. Fluid outflow in the rat spinal cord: the role of perivascular and paravascular pathways - fluids and barriers of the cns 4. Characteristics of csf velocity-time profile in posttraumatic syringomyelia - american journal of neuroradiology the pathophysiology of sm has been a mystery for nearly five centuries. The work above, along with our work in the last decade, has exponentially increased the science community's knowledge of how cm, trauma, and arachnoiditis cause sm. It is our hope that this knowledge will allow us to define the surgical outcomes required to stop the damage and pain of sm while we search for ways to potentially prevent sm and or cure it non surgically. Past work has allowed us to find a way to remove fluid from a syrinx without surgery and to measure fluid flow in and out of the spinal cord in vivo. The current work is focused on the exact pathways of fluid inflow and outflow along the spinal cord. We have discovered that the pathways not only vary from the pathways in the brain but also vary from in different sections of the spinal cord.

at the date of issuance, coh has committed in excess of 150,000 to continue with our research and commitment to convert our basic research findings include diagnostic and treatment tools for physicians to benefit current patients. We expect to sign a contract to hold an international sm/cm/eds conference in mid-2019 with the goal to increase shared knowledge and collaboration among scientists as well as physicians attempt to agree on criteria for positive outcomes in cm/sm/eds treatment.