Arnold-Chiari malformation--a closer look

Arnold-Chiari malformation (ACM) is a malformation of the cervico-medullary junction characterized by displacement of the cerebellar tonsils, the brainstem and the fourth ventricle into the upper cervical canal. The clinical presentation of this anomaly is largely dependent upon age at onset, associated pathology, and the presence of hydromyelia. Considerable controversy exists within the literature concerning pathogenesis, signs and symptoms, diagnosis, and successful treatment of Arnold-Chiari malformation. This article will examine these issues and discuss the nursing management of patients with this syndrome.