Arnold-Chiari malformation is a group of deformities seen in the hindbrain that is cerebellum, pons, and medulla oblongata. Based on the morphology of the malformations as seen radiologically or during an autopsy, Chiari II includes brainstem, fourth ventricle, and greater than 5 mm descent of the caudal tip of cerebellar tonsils past the foramen magnum with spina bifida.
In the present case, a report of anesthetic management of a 29-year-old school clerk presented with hydrocephalus and myelomeningocele and MR imaging revealed herniation of cerebellum and medulla through foramen magnum, hence, confirming it to be a case of type II Chiari malformation posted for ventriculoperitoneal shunting and foramen magnum decompression.
Balaji K, Pratap R, et al. Anaesthetic management in a patient with Arnold-Chiari malformation type I and Syringomyelia. J Evol Med Dent Sci 2013;2(17):2908–2911.
Hassan A, Yaseen S, et al. Arnold-Chiari Malformation: Anatomical Variations and Latest Embryological Perspective. Review of Literature. Int J Contemp Med Res 2016;3(5):1489–1491.
Kural C, Solmaz I, et al. Evaluation and management of lumbosacral myelomeningoceles in children. Eurasian J Med 2015;47(3):174. DOI: 10.5152/eurasianjmed.2015.138.
Stevenson KL. Chiari type II malformation: past, present and future. Neurosurg Focus 2004 Feb 15;16(2): E5.
Gammal EL, Mark EK, et al. MR imaging of Chiari II malformation. AJR Am J Roentgenol 1988;150:163–170. DOI: 10.2214/ajr.150.1.163
Rauzzino M, Oakes WJ. Chiari II malformation and syringomyelia. Neurosurg Clin N Am 1995;6:293–309.
Kim TY, Lee C, et al. Anesthetic management of a patient with Arnold- Chiari malformation type I with associated syringomyelia: A case report. Reg Anesth Pain Med 2012;7(2):166–169.
