Acquired Chiari malformation following spinal cord injury—a case series

McKean, David; Zishan, Umme Sara; Billingsley, Sarah; Swarna, Shyam S; O’Neill, Cormac; Banerjee, Monika; Siddiqi, Safa; Papanikitas, Joseph; Yanny, Sarah; Hughes, Richard J.; Meagher, Tom

doi:10.1038/s41394-019-0211-y

Cited by 4 publications

(1 citation statement)

References 21 publications

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“…Since 1981, these novel terms have been widely used in case reports and series on various conditions, including tonsillar herniation secondary lumboperitoneal shunt 131 , chronic subdural hematoma 132 , spontaneous CSF leakage 133 , fatty terminal lum 134 , hyperostotic skull formation 135 , PCF tumour 136 or arachnoid cyst 137 , arteriovenous malformation 138 , spinal cord injury 139 , and Paget's disease 140 .…”

Section: Limitations Of Usage Of Morphological Nomenclaturementioning

confidence: 99%

Research process, recap, and prediction of Chiari malformation based on bicentennial history of nomenclature and terms misuse

He,

Zhang,

Qin

et al. 2023

Neurosurg Rev

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Section: Limitations Of Usage Of Morphological Nomenclaturementioning

confidence: 99%

Research process, recap, and prediction of Chiari malformation based on bicentennial history of nomenclature and terms misuse

He,

Zhang,

Qin

et al. 2023

Neurosurg Rev

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Laryngeal and swallow dysregulation following acute cervical spinal cord injury

Pitts

Iceman

Huff³

et al. 2021

Preprint

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Proper function of the larynx is vital to airway protection, including swallow. While the swallow reflex is controlled by the brainstem, patients with cervical spinal cord injuries (cSCI) are likely at increased risk of disordered swallow (dysphagia) and pneumonia, and the underlying mechanisms are unknown. We aimed to determine if acute spinal cord injury would disrupt swallow function in animal models. We hypothesized that 1) loss of descending efferent information to the diaphragm would affect swallow and breathing differently, and that 2) loss of ascending spinal afferent information would alter central swallow regulation to change motor drive to the upper airway. We recorded amplitudes of laryngeal and inspiratory muscle electromyograms (EMGs), submental and pharyngeal muscle EMGs, and cardiorespiratory measures in freely breathing pentobarbital-anesthetized cats and rats. First, we assessed the effect of a lateral hemisection at the second cervical level (C2) in cats during breathing. Posterior cricoarytenoid (laryngeal abductor) EMG activity during inspiration increased nearly two-fold, indicating that inspiratory laryngeal drive increased following cSCI. Ipsilateral to the injury, the crural diaphragm EMG was significantly reduced during breathing (62 ± 25 percent change post-injury), but no animal had a complete termination of all activity; 75% of animals had an increase in contralateral diaphragm recruitment after cSCI, but this did not reach significance. Next, we assessed the effect of C2 lateral hemisection in cats during swallow. The thyroarytenoid (laryngeal adductor) and thyropharyngeus (pharyngeal constrictor) both increased EMG activity during swallow, indicating increased upper airway drive during swallow following cSCI. There was no change in the number of swallows stimulated per trial. We also found that diaphragm activity during swallow (schluckatmung) was bilaterally suppressed after lateral C2 hemisection, which was unexpected because this injury did not suppress contralateral diaphragm activity during breathing. Swallow-breathing coordination was also affected by cSCI, with more post-injury swallows occurring during early expiration. Finally, because we wanted to determine if the chest wall is a major source of feedback for laryngeal regulation, we performed T1 total transections in rats. As in the cat C2 lateral hemisection, a similar increase in inspiratory laryngeal activity (posterior cricoarytenoid) was the first feature noted after rat T1 complete spinal cord transection. In contrast to the cat C2 lateral hemisection, diaphragmatic respiratory drive increased after T1 transection in every rat (215 ± 63 percent change), and this effect was significant. Overall, we found that spinal cord injury alters laryngeal drive during swallow and breathing, and alters swallow-related diaphragm activity. Our results show behavior-specific effects, suggesting that swallow may be more affected than breathing is by cSCI, and emphasizing the need for additional studies on laryngeal function during breathing and swallow after spinal cord injury.

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Arnold-Chiari Malformation: Core Concepts

Fons¹

2021

Neonatal Network

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Arnold-Chiari malformation (ACM), a defect that involves downward displacement of the hindbrain and herniation of the cerebellar vermis, tonsils, pons, medulla, and fourth ventricle through the foramen magnum, is the most complex of the 4 types of Chiari malformations. Unique to the other types of Chiari malformations, approximately 95 percent of infants with ACM also present with an associated myelomeningocele (MMC), the most severe form of spina bifida. Among affected infants, those with symptomatic comorbidities incur a significantly higher morbidity and mortality risk. Prompt identification and diagnosis of ACM, as well as evidence-based postnatal and postsurgical nursing and medical care, is critical. Early surgical intervention can repair an existing MMC and restore proper cerebrospinal fluid circulation, which can dramatically improve patient outcomes and quality of life, and reduce disease and health care burden.

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Acquired Chiari malformation following spinal cord injury—a case series

Cited by 4 publications

References 21 publications

Research process, recap, and prediction of Chiari malformation based on bicentennial history of nomenclature and terms misuse

Research process, recap, and prediction of Chiari malformation based on bicentennial history of nomenclature and terms misuse

Laryngeal and swallow dysregulation following acute cervical spinal cord injury

Arnold-Chiari Malformation: Core Concepts

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