Document Detail

Urgent surgical intervention in pediatric patients with Chiari malformation type I. Report of two cases.
MedLine Citation:
PMID:  17647308     Owner:  NLM     Status:  MEDLINE    
Patients with Chiari malformation Type I (CM-I) most commonly present with chronic symptoms. A search of the current medical literature revealed scant information regarding acute presentations of CM-I in either pediatric or adult patients. The authors report on two children who presented with rapidly worsening neurological symptoms attributable to a previously undiagnosed CM-I. One patient became profoundly hypopneic with dysphagia and right hemiparesis over a less than 48-hour period. The second patient presented with a few days of worsening right hemiparesis, gait disturbance, and anisocoria. In addition to a CM-I, magnetic resonance imaging in the second patient revealed a holocord syrinx. Following urgent posterior fossa decompression, both patients rapidly improved in the 24 hours immediately following surgery and continued to improve in the subsequent weeks. Few reports detail acute symptoms due to CM-I and those that do exist almost exclusively involve adult patients. Although seemingly rare, the clinician should consider CM-I in the differential diagnosis in pediatric patients presenting with acute brainstem or long tract signs.
John C Wellons; R Shane Tubbs; Cuong J Bui; Paul A Grabb; W Jerry Oakes
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  107     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-24     Completed Date:  2007-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-52     Citation Subset:  AIM; IM    
Division of Neurosurgery, Section of Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama 35233, USA.
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MeSH Terms
Acute Disease
Arnold-Chiari Malformation / complications,  diagnosis,  surgery*
Decompression, Surgical
Diagnosis, Differential
Encephalocele / complications,  diagnosis,  surgery
Magnetic Resonance Imaging
Neurologic Examination
Peripheral Nervous System Diseases / diagnosis,  etiology*,  surgery
Syringomyelia / diagnosis,  surgery
Tomography, X-Ray Computed

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