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Airway Management of Type-III Arnold Chiari Malformation: An Anaesthetic Challenge

Sasmita Panigrahy1, Soumya Samal1, Sulochana Dash1

  • 1Department of Anaesthesiology and Critical Care, IMS & SUM Hospital, SOA deemed to be University, Bhubaneswar -751003, Odisha, India.

Romanian Journal of Anaesthesia and Intensive Care
|February 27, 2023
PubMed

Insights

This case report details a rare Type III Arnold Chiari malformation (ACM) with an occipitomeningoencephalocele. It highlights the significant anesthetic challenges and management strategies for this complex congenital defect.

Area of Science:

  • Neurology
  • Pediatric Neurosurgery
  • Anesthesiology

Background:

  • Arnold Chiari malformation (ACM) involves brain and meninges protrusion through cranial or vertebral defects.
  • Type III ACM, the rarest form, often presents with encephalocele.

Purpose of the Study:

  • To report a rare case of Type III ACM with a large occipitomeningoencephalocele.
  • To outline the anesthetic challenges and management strategies for this condition.

Main Methods:

  • Detailed description of a patient with Type III ACM and occipitomeningoencephalocele.
  • Discussion of preoperative, intraoperative, and postoperative anesthetic considerations.

Main Results:

  • The case involved herniation of dysmorphic cerebellum, vermis, and medulla, with cerebrospinal fluid, spinal cord tethering, and vertebral defects.
  • Successful management required careful attention to airway, intracranial pressure, and patient positioning.

Conclusions:

  • Type III ACM with occipitomeningoencephalocele presents unique and significant anesthetic challenges.
  • Comprehensive preoperative assessment and meticulous intraoperative management are crucial for patient safety.

Keywords:
Arnold Chiari malformationcerebellumoccipitomeningoencephalocele

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