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Published in: Child's Nervous System 8/2009

01-08-2009 | Case Report

Pseudotumor cerebri: as a cause for early deterioration after Chiari I malformation surgery

Authors: Sunil V. Furtado, K. Visvanathan, Kalyan Reddy, A. S. Hegde

Published in: Child's Nervous System | Issue 8/2009

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Abstract

Introduction

Chiari I malformation is associated with a small posterior fossa which cannot accommodate a growing hindbrain. Pseudotumor cerebri has been linked to developmental posterior fossa malformations.

Case reports

The authors present two cases of early-deterioration post-Chiari I malformation surgery in a young and an adult patient, which were linked to raised intracranial pressure and had a stormy post-operative period. The pathophysiology of pseudotumor cerebri in early post-operative complications of Chiari malformation surgery is addressed along with arguments favoring its association.

Discussion

Potential clinical risk factors and red flags linking pseudotumor cerebri and Chiari malformation patients are discussed. The management of post-operative complications produced by the association is addressed.
Literature
1.
go back to reference Banik R, Lin D, Miller NR (2006) Prevalence of Chiari I malformation and cerebellar ectopia in patients with pseudotumor cerebri. J Neurol Sci 247:71–75PubMedCrossRef Banik R, Lin D, Miller NR (2006) Prevalence of Chiari I malformation and cerebellar ectopia in patients with pseudotumor cerebri. J Neurol Sci 247:71–75PubMedCrossRef
2.
go back to reference Bosma JJ, Kumaran N, May PL (2002) Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation. Childs Nerv Syst 18:474–477PubMedCrossRef Bosma JJ, Kumaran N, May PL (2002) Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation. Childs Nerv Syst 18:474–477PubMedCrossRef
3.
go back to reference Cinalli G, Spennato P, Sainte-Rose C, Arnaud E, Aliberti F, Brunelle F, Cianciulli E, Renier D (2005) Chiari malformation in craniosynostosis. Childs Nerv Syst 21:889–901PubMedCrossRef Cinalli G, Spennato P, Sainte-Rose C, Arnaud E, Aliberti F, Brunelle F, Cianciulli E, Renier D (2005) Chiari malformation in craniosynostosis. Childs Nerv Syst 21:889–901PubMedCrossRef
4.
go back to reference Di Rocco C, Velardi F (2003) Acquired Chiari type I malformation managed by supratentorial cranial enlargement. Childs Nerv Syst 19:800–807PubMedCrossRef Di Rocco C, Velardi F (2003) Acquired Chiari type I malformation managed by supratentorial cranial enlargement. Childs Nerv Syst 19:800–807PubMedCrossRef
5.
go back to reference Fagan LH, Ferguson S, Yassari R, Frim DM (2006) The Chiari pseudotumor cerebri syndrome: symptom recurrence after decompressive surgery for Chiari malformation type I. Pediatr Neurosurg 42:14–19PubMedCrossRef Fagan LH, Ferguson S, Yassari R, Frim DM (2006) The Chiari pseudotumor cerebri syndrome: symptom recurrence after decompressive surgery for Chiari malformation type I. Pediatr Neurosurg 42:14–19PubMedCrossRef
6.
go back to reference Gökalp HZ, Başkaya MK, Aydin V (1992) Pseudotumor cerebri with familial Mediterranean fever. Clin Neurol Neurosurg 94:261–263PubMedCrossRef Gökalp HZ, Başkaya MK, Aydin V (1992) Pseudotumor cerebri with familial Mediterranean fever. Clin Neurol Neurosurg 94:261–263PubMedCrossRef
7.
go back to reference Jatavallabhula NS, Armstrong J, Sgouros S, Whitehouse W (2006) Spontaneous resolution of isolated Chiari I malformation. Childs Nerv Syst 22:201–203PubMedCrossRef Jatavallabhula NS, Armstrong J, Sgouros S, Whitehouse W (2006) Spontaneous resolution of isolated Chiari I malformation. Childs Nerv Syst 22:201–203PubMedCrossRef
8.
go back to reference Johnston I, Jacobson E, Besser M (1998) The acquired Chiari malformation and syringomyelia following spinal CSF drainage: a study of incidence and management. Acta Neurochir (Wien) 140:417–427CrossRef Johnston I, Jacobson E, Besser M (1998) The acquired Chiari malformation and syringomyelia following spinal CSF drainage: a study of incidence and management. Acta Neurochir (Wien) 140:417–427CrossRef
9.
go back to reference Johnston I, Kollar C, Dunkley S, Assaad N, Parker G (2002) Cranial venous outflow obstruction in the pseudotumour syndrome: incidence, nature and relevance. J Clin Neurosci 9:273–278PubMedCrossRef Johnston I, Kollar C, Dunkley S, Assaad N, Parker G (2002) Cranial venous outflow obstruction in the pseudotumour syndrome: incidence, nature and relevance. J Clin Neurosci 9:273–278PubMedCrossRef
10.
go back to reference Kollar CD, Johnston IH (1999) Pseudotumour after arteriovenous malformation embolization. J Neurol Neurosurg Psychiatry 67:249PubMedCrossRef Kollar CD, Johnston IH (1999) Pseudotumour after arteriovenous malformation embolization. J Neurol Neurosurg Psychiatry 67:249PubMedCrossRef
11.
go back to reference Menezes AH (2002) Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation. Childs Nerv Syst 18:483–484PubMedCrossRef Menezes AH (2002) Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation. Childs Nerv Syst 18:483–484PubMedCrossRef
12.
go back to reference Mikulis DJ, Diaz O, Egglin TK, Sanchez R (1992) Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology 183:725–728PubMed Mikulis DJ, Diaz O, Egglin TK, Sanchez R (1992) Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology 183:725–728PubMed
13.
go back to reference Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, Speer MC (1999) Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 44:1005–1017PubMedCrossRef Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, Speer MC (1999) Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 44:1005–1017PubMedCrossRef
14.
go back to reference Rekate HL (1992) Brain turgor (Kb) intrinsic property of the brain to resist distortion. Pediatr Neurosurg; 18:257–262PubMedCrossRef Rekate HL (1992) Brain turgor (Kb) intrinsic property of the brain to resist distortion. Pediatr Neurosurg; 18:257–262PubMedCrossRef
15.
go back to reference Rekate HL (2002) Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation. Childs Nerv Syst 18:482PubMedCrossRef Rekate HL (2002) Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation. Childs Nerv Syst 18:482PubMedCrossRef
16.
go back to reference Sahin B, Acer N, Sonmez OF, Emirzeoglu M, Basaloglu H, Uzun A, Bilgic S (2007) Comparison of four methods for the estimation of intracranial volume: a gold standard study. Clin Anat 20:766–773PubMedCrossRef Sahin B, Acer N, Sonmez OF, Emirzeoglu M, Basaloglu H, Uzun A, Bilgic S (2007) Comparison of four methods for the estimation of intracranial volume: a gold standard study. Clin Anat 20:766–773PubMedCrossRef
17.
go back to reference Sinclair N, Assaad N, Johnston I (2002) Pseudotumour cerebri occurring in association with the Chiari malformation. J Clin Neurosci 9:99–101PubMedCrossRef Sinclair N, Assaad N, Johnston I (2002) Pseudotumour cerebri occurring in association with the Chiari malformation. J Clin Neurosci 9:99–101PubMedCrossRef
18.
go back to reference Thapa R, Mukherjee S (2008) Transient bilateral oculomotor palsy in pseudotumor cerebri. J Child Neurol 23:580–581PubMedCrossRef Thapa R, Mukherjee S (2008) Transient bilateral oculomotor palsy in pseudotumor cerebri. J Child Neurol 23:580–581PubMedCrossRef
19.
go back to reference Williams B (1980) On the pathogenesis of syringomyelia: a review. J R Soc Med 73:798–806PubMed Williams B (1980) On the pathogenesis of syringomyelia: a review. J R Soc Med 73:798–806PubMed
Metadata
Title
Pseudotumor cerebri: as a cause for early deterioration after Chiari I malformation surgery
Authors
Sunil V. Furtado
K. Visvanathan
Kalyan Reddy
A. S. Hegde
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 8/2009
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-009-0854-2

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