Insuffisance respiratoire aiguë isolée révélant une malformation d’Arnold-Chiari

Coronavirus disease 2019–associated persistent cough and Chiari malformation type I resulting in acute respiratory failure: illustrative case

“…36 Although a number of conditions have been associated with acute exacerbations of symptomatology in CM-I, acute respiratory failure has been described in the literature fewer than five times and never in association with COVID-19. 19,23,24 The patient reported herein was otherwise asymptomatic until she contracted COVID-19 with constant, severe coughing fits. Several weeks later, she began waking up one to two times per night confused and gasping for breath, which worsened over the following months and progressed with additional symptoms of gait instability, blurry vision, dysphagia, and vertigo.…”

“…[12][13][14][15][16] This acute presentation often consists of progressively worsening occipital headaches, hypoxemia, hypercapnia, neurological deficits, and imaging studies demonstrating an enlarged fourth ventricle, cervical cord syrinx, and/or signs of posterior fossa crowding. [17][18][19][20] Surgical decompression is considered the gold standard treatment with the goal of reversing the respiratory symptomatology, which has been reported in a number of cases. 12,16,[20][21][22] Although SDB and other stressors have been associated with respiratory distress in CM-I, respiratory failure as the initial presentation of CM-I has seldom been described, with only 4 known cases reported in the literature.…”

“…12,16,[20][21][22] Although SDB and other stressors have been associated with respiratory distress in CM-I, respiratory failure as the initial presentation of CM-I has seldom been described, with only 4 known cases reported in the literature. 19,23,24 To date, coronavirus disease 2019 (COVID-19) infection has numbered over 768 million cases worldwide and 6.9 million deaths primarily due to severe hypoxemia and acute respiratory distress syndrome. 25,26 Infection with COVID-19 as the inciting event in a patient with CM-I, leading to SDB and loss of the CO 2 drive to breathe during sleep, causing acute respiratory failure, has not been reported in the literature.…”