Respiratory arrest: a complication of cerebellar ectopia in adults.

Abstract

Two adult patients are described with cerebellar ectopia whose presentation at diagnosis was respiratory arrest. Following surgical decompression both patients become self ventilating and now lead independent lives. Cerebellar ectopia is a potentially remediable condition and should be considered in patients with unexplained respiratory arrest.

Acute respiratory arrest following partial suboccipital cranioplasty for cerebellar ptosis from Chiari malformation decompression

“…Additionally, acute respiratory arrest has been reported previously at 2, 3, and 42 hours, and as late as 2 months after suboccipital craniectomy for CM-I. 5,9,14,27 Sudden respiratory deterioration due to the initial procedure has been described, possibly as a result of the loss of respiratory center neurons in the morbid condition, with this loss possibly due to congenital deformity or lengthy compression. 15,23 Although there was no obvious tether identified intraoperatively on the spinal cord or brainstem in either case, one wonders if stretching on the vulnerable cervicomedullary junction from the elevation of the cerebellum during the cerebellar shelving procedure is possibly responsible.…”

Sleep Apneas, Convulsive Syncopes and Autonomic Impairment in Type I Arnold-Chiari Malformation

“…Respiratory fail ure and central sleep apneas have been described due to compression of the medulla [1][2][3] or insensitivity of peripheral chemoreceptors [4], Less frequently, obstruc tive sleep apneas were observed [5,6]. In 1 patient we documented a respiratory and autonomic dysfunction leading to a life-threatening breathing and hemodynamic pattern during sleep.…”

Malformação de Chiari tipo I: relato de dois casos com apresentações clínicas pouco usuais

“…Fish e colaboradores enfatizaram a parada respiratória como uma complicação de ectopia cerebelar em adultos 9 .…”

“…Outro distúrbio respiratório encontrado em associação com a malformação de Chiari é a síndrome da apnéia do sono obstrutiva [6][7][8][9] .…”

“…O diagnóstico, por vezes, é de difícil realização, em face do quadro clínico neurológico multiforme e de exames complementares pouco elucidativos, sendo raras as apresentações com insuficiência respiratória aguda, síndrome vestibular e cerebelar associadas e cefaléia [6][7][8][9] .…”