Improvement of obstructive sleep apneas caused by hydrocephalus associated with Chiari malformation Type II following surgery.
J Neurosurg Pediatr
; 6(4): 336-9, 2010 Oct.
Article
em En
| MEDLINE
| ID: mdl-20887105
ABSTRACT
Chiari malformation (CM) is the downward herniation of the caudal part of the cerebellum and/or medulla oblongata into the spinal canal. It can alter several neurological functions, including respiratory control and upper airway motility, and can be the cause of sleep-disordered breathing (SDB). The authors describe a 6-year-old boy affected by CM Type II associated with myelomeningocele who showed symptoms indicative of severe airway obstruction during sleep. Polysomnography revealed severe obstructive sleep apnea syndrome (OSAS). Magnetic resonance imaging demonstrated herniation of the cerebellar tonsils and diffuse ventricular dilation with a large pseudocystic formation in the third ventricle. Surgical marsupialization of the cystic wall was performed, associated with ventriculocystostomy and endoscopic replacement of the ventricular catheter. Polysomnography repeated 2 months after surgery revealed a striking improvement in the sleep-related respiratory pattern. The pathogenesis of OSAS was probably referable to a combination of CM and elevated intracranial pressure. However, the striking improvement of symptoms after ventriculoatrial shunt placement suggested that hydrocephalus plays a major role in this condition. Assessment and effective treatment of SDB is crucial in the care of patients with CM.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Cirurgia_oncologica
Base de dados:
MEDLINE
Assunto principal:
Malformação de Arnold-Chiari
/
Apneia Obstrutiva do Sono
/
Hidrocefalia
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
/
Male
Idioma:
En
Revista:
J Neurosurg Pediatr
Assunto da revista:
NEUROCIRURGIA
/
PEDIATRIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Itália