• M Burhan Janjua, Iryna Ivasyk, and Jeffrey P Greenfield.
• Department of Neurological Surgery, Weill Cornell Medical College And New York Presbyterian Hospital, New York, New York, USA. Electronic address: mburhanj@gmail.com.
• World Neurosurg. 2017 Aug 1; 104: 1050.e1-1050.e6.

BackgroundChiari malformation is characterized by radiographic evidence of herniation of cerebellar tonsils below the foramen magnum and a symptom complex of headaches; breathing, swallowing, or sleep difficulties; ataxia; restless; and motor and/or sensory deficits.Case DescriptionWe report a case of a 34-year-old woman whose imaging indicated a Chiari 1.5 with brainstem (caudal medulla) herniation and an expansive cervical syrinx. Her symptom complex showed signs both of cervical syringomyelia, as well as ones localizable to the medulla. An intradural exploration revealed the occlusion and caudal displacement of the loop of the right posterior inferior cerebellar artery, which was later confirmed via magnetic resonance angiography.ConclusionsIn the setting of severe Chiari malformations, particularly the Chiari 1.5 variant, assessment of the posterior fossa vasculature may be useful in defining a subset of patients with preoperative compromise in posterior fossa blood flow and postoperative expectations. Preoperative planning and exploration of midline dorsal brain stem along with the tonsilomedullary fissure could be helpful for contribution of vascular pathology among Chiari symptoms complex in these patients.Copyright © 2017 Elsevier Inc. All rights reserved.

24 keywords...

hide…