Recurrent aspiration due to Arnold-Chiari type I malformation.

Nathadwarawala, K M; Richards, Catherine; Lawrie, B W; Thomas, Gareth O.; Wiles, C M

doi:10.1136/bmj.304.6826.565

Cited by 17 publications

(8 citation statements)

References 3 publications

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“…Most cases of Arnold-Chiari malformation are designated as type I based on the caudal displacement of the cerebellar tonsils into the upper cervical spinal canal [7][8][9]. Although this type of herniation may be asymptomatic, a few previous studies have reported cases in which patients with an Arnold-Chiari malformation type I developed an acute type II respiratory failure [10][11][12]. Campisi et al and Nathadwarawala et al have reported that an adult with Arnold-Chiari malformation type I may initially present with recurrent aspiration, secondary bronchiectasis, dysphagia, or central sleep apnea [10,11].…”

Section: Discussionmentioning

confidence: 99%

Arnold–Chiari malformation type I and the posterior dislocation of the odontoid process aggravate prolonged weaning in a patient with severe viral pneumonia: a case report

et al. 2020

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Background: Prolonged and difficult weaning is associated with higher rates of complications and mortality. Therefore, it is important to identify the associated factors. Case presentation: We describe our experience with a 37-year-old man diagnosed with severe viral pneumonia (influenza A). He presented with acute respiratory failure type I on admission. During intubation, his blood pressure and heart rate decreased, and epinephrine and norepinephrine were administered. Although his clinical condition improved 8 days after intensive care unit (ICU) admission, he experienced difficulty weaning. He remained conscious but had a poor spontaneous cough with sputum production and weak limb muscle strength. His cough reflex was absent during bronchoscopic sputum suction, and he used abdominal breathing during the T-tube test. Magnetic resonance imaging revealed an Arnold-Chiari malformation type I, posterior dislocation of the odontoid process, and syringomyelia, with compression and deformation of the medulla and high cervical cord. The patient was successfully weaned from the ventilator at 20 days after ICU admission. Conclusions: Arnold-Chiari malformation type I and posterior dislocation of the odontoid process, which aggravate medullary compression and increase the risk of cervical nerve injury, might be a rare factor affecting prolonged weaning in critical illness.

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Section: Discussionmentioning

confidence: 99%

Arnold–Chiari malformation type I and the posterior dislocation of the odontoid process aggravate prolonged weaning in a patient with severe viral pneumonia: a case report

et al. 2020

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“…Dysphagia: Swallowing difficulty and neurogenic dysphagia are symptoms that can be rapidly progressive and lead to aspiration if undetected (Elta, Caldwell, & Nostrant, 1996;Nathadwarawala, Richards, Lawrie, Thomas, & Wiles, 1992;Pollack, Pang, Kosochis, & Putnam, 1992). Dysphagia is one of the cardinal signs of compression of the cerebellum and lower cranial nerves.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Brainstem Conundrum: The Chiari I Malformation

Mueller

2001

Journal of the American Academy of Nurse Practitioners

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Case StudyMs. S was a 35-year old woman with approximately seven years of progressive neurologic deterioration. Her primary presenting symptoms included posterior-occipital headaches, described as intense pressure and often associated with nausea; shortness of breath, unrelated to exertion; and dizziness. She reported progressive numbness in the hands and had unknowingly burned herself on several occasions. Weakness of the extremities had progressed to inability to hold objects and gait instability. The neurologic examination was remarkable for significant weakness of the upper and lower extremities, numbness throughout the left, and gait ataxia. She had been treated conservatively by her primary care provider for approximately eight years for stress and underwent an admission to psychiatry for a presumed diagnosis of conversion reaction. A magnetic resonance imaging (MRI) scan was performed and demonstrated approximately 10mm tonsillar herniation consistent with Chiari I Malformation, and syringomyelia extending from cervical three to thoracic nine level.

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“…The task is not only to differentiate traumatic and natural death but also to identify predisposing disorders and contributory factors. In this respect, neurological disorders are important predispositions to unexpected death involving aspiration, pneumonia and convulsions [1][2][3]. Furthermore, deficits in the arousal response are suggested to be an underlying factor for sudden infant death syndrome (SIDS) [4].…”

Section: Introductionmentioning

confidence: 99%

An autopsy case of an infant with Joubert syndrome who died unexpectedly and a review of the literature

Ishikawa

Zhu

et al. 2008

Forensic Science International

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Recurrent aspiration due to Arnold-Chiari type I malformation.

Abstract: Recurrent aspiration and dysphagia may be the only initial symptoms in an adult presenting with an Arnold Chiari type I malformation.

Cited by 17 publications

References 3 publications

Arnold–Chiari malformation type I and the posterior dislocation of the odontoid process aggravate prolonged weaning in a patient with severe viral pneumonia: a case report

Arnold–Chiari malformation type I and the posterior dislocation of the odontoid process aggravate prolonged weaning in a patient with severe viral pneumonia: a case report

Brainstem Conundrum: The Chiari I Malformation

An autopsy case of an infant with Joubert syndrome who died unexpectedly and a review of the literature

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