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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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Atypical presentations in Chiari II malformation.

G P Rath1, P K Bithal, A Chaturvedi

  • 1Department of Neuroanaesthesiology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.

Pediatric Neurosurgery
|October 19, 2006
PubMed
Summary

Myelomeningocele, Chiari II malformation, and hydrocephalus can cause varied infant complications. Surgical intervention for these conditions can effectively resolve issues like vocal cord paralysis and cardiac arrest.

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Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Congenital Malformations

Background:

  • Myelomeningocele, Chiari II malformation, and hydrocephalus frequently occur together due to congenital neurulation defects.
  • This association presents a spectrum of potential clinical challenges in affected infants.

Observation:

  • Two cases highlight diverse presentations: one with severe inspiratory stridor from bilateral abductor vocal cord paralysis, the other with intraoperative cardiac arrest.
  • Both infants underwent definitive surgical repair for their respective conditions.

Findings:

  • The inspiratory stridor in the first case resolved within 24 hours post-surgery.
  • The second patient required successful cardiopulmonary resuscitation during surgery.

Implications:

  • Chiari II malformation's associated pathologies are implicated as the cause of the perioperative events in both cases.
  • Early surgical management is crucial for addressing life-threatening complications in infants with this complex malformation syndrome.