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Child's Nervous System
Published in: Child's Nervous System 8/2012

01-08-2012 | Case Report

Acquired and reversible Chiari-like descent following a single lumbar puncture: case report

Authors: N. Pencovich, L. Ben-Sira, A. Kesler, S. Constantini

Published in: Child's Nervous System | Issue 8/2012

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Excerpt

Chiari malformation type I (CMI), a condition that consists of caudal herniation of the cerebellar tonsils through the foramen magnum, was originally considered a congenital abnormality. In recent years, numerous reports have documented the development of acquired CMI secondary to various medical conditions and procedures such as lumbar–peritoneal shunting [6], cerebrospinal fluid (CSF) drainage [8], trauma [23], tumors [12, 24], multiple lumbar punctures (LP) [21], and others [1, 3]. Here, we describe a 16-year-old boy who developed a Chiari-like caudal descent of the cerebellar tonsils accompanied by compression of posterior fossa cisterns following a single diagnostic lumbar puncture. The pathophysiology and clinical implications of such a phenomenon in relation to known causes of acquired Chiari are discussed. …
Literature
1.
Albert L Jr, Hirschfeld A (2009) Acquired Chiari malformation secondary to hyperostosis of the skull: a case report and literature review. Surg Neurol 72:157–161PubMedCrossRef
2.
Badie B, Mendoza D, Batzdorf U (1995) Posterior fossa volume and response to suboccipital decompression in patients with Chiari I malformation. Neurosurgery 37:214–218PubMedCrossRef
3.
Bahuleyan B, Rao A, Chacko AG, Daniel RT (2007) Supracerebellar arachnoid cyst—a rare cause of acquired Chiari I malformation. J Clin Neurosci 14:895–898PubMedCrossRef
4.
Boon JM, Abrahams PH, Meiring JH, Welch T (2004) Lumbar puncture: anatomical review of a clinical skill. Clin Anat 17:544–553PubMedCrossRef
5.
Chumas PD, Drake JM, Del Bigio MR (1992) Death from chronic tonsillar herniation in a patient with lumboperitoneal shunt and Crouzon’s disease. Br J Neurosurg 6:595–599PubMedCrossRef
6.
Chumas PD, Armstrong DC, Drake JM, Kulkarni AV, Hoffman HJ, Humphreys RP, Rutka JT, Hendrick EB (1993) Tonsillar herniation: the rule rather than the exception after lumboperitoneal shunting in the pediatric population. J Neurosurg 78:568–573PubMedCrossRef
7.
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
8.
Dagnew E, van Loveren HR, Tew JM Jr (2002) Acute foramen magnum syndrome caused by an acquired Chiari malformation after lumbar drainage of cerebrospinal fluid: report of three cases. Neurosurgery 51:823–828, discussion 828–829PubMed
9.
Di Rocco C, Frassanito P, Massimi L, Peraio S (2011) Hydrocephalus and Chiari type I malformation. Childs Nerv Syst 27:1653–1664PubMedCrossRef
10.
Di Rocco C, Velardi F (2003) Acquired Chiari type I malformation managed by supratentorial cranial enlargement. Childs Nerv Syst 19:800–807PubMedCrossRef
11.
12.
Fox B, Muzumdar D, DeMonte F (2005) Resolution of tonsillar herniation and cervical syringomyelia following resection of a large petrous meningioma: case report and review of literature. Skull Base 15:89–97, discussion 98PubMedCrossRef
13.
Girard N, Lasjaunias P, Taylor W (1994) Reversible tonsillar prolapse in vein of Galen aneurysmal malformations: report of eight cases and pathophysiological hypothesis. Childs Nerv Syst 10:141–147PubMedCrossRef
14.
Huang PP, Constantini S (1994) “Acquired” Chiari I malformation. Case report. J Neurosurg 80:1099–1102PubMedCrossRef
15.
Joffe AR (2007) Lumbar puncture and brain herniation in acute bacterial meningitis: a review. J Intensive Care Med 22:194–207PubMedCrossRef
16.
Marin-Padilla M, Marin-Padilla TM (1981) Morphogenesis of experimentally induced Arnold–Chiari malformation. J Neurol Sci 50:29–55PubMedCrossRef
17.
Menezes AH (1995) Primary craniovertebral anomalies and the hindbrain herniation syndrome (Chiari I): data base analysis. Pediatr Neurosurg 23:260–269PubMedCrossRef
18.
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
19.
Nishikawa M, Sakamoto H, Hakuba A, Nakanishi N, Inoue Y (1997) Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa. J Neurosurg 86:40–47PubMedCrossRef
20.
Rekate HL (2002) Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation. Childs Nerv Syst 18:482PubMedCrossRef
21.
Sathi S, Stieg PE (1993) “Acquired” Chiari I malformation after multiple lumbar punctures: case report. Neurosurgery 32:306–309, discussion 309PubMedCrossRef
22.
Schijman E (2004) History, anatomic forms, and pathogenesis of Chiari I malformations. Childs Nerv Syst 20:323–328PubMedCrossRef
23.
Scholsem M, Scholtes F, Belachew S, Martin D (2008) Acquired tonsillar herniation and syringomyelia after pleural effusion aspiration: case report. Neurosurgery 62:E1172–E1173, discussion E1173PubMedCrossRef
24.
Sheehan JM, Jane JA Sr (2000) Resolution of tonsillar herniation and syringomyelia after supratentorial tumor resection: case report and review of the literature. Neurosurgery 47:233–235PubMed
25.
Stovner LJ, Bergan U, Nilsen G, Sjaastad O (1993) Posterior cranial fossa dimensions in the Chiari I malformation: relation to pathogenesis and clinical presentation. Neuroradiology 35:113–118PubMedCrossRef
26.
Tubbs RS, Lyerly MJ, Loukas M, Shoja MM, Oakes WJ (2007) The pediatric Chiari I malformation: a review. Childs Nerv Syst 23:1239–1250PubMedCrossRef
27.
van Crevel H, Hijdra A, de Gans J (2002) Lumbar puncture and the risk of herniation: when should we first perform CT? J Neurol 249:129–137PubMedCrossRef
28.
Vega A, Quintana F, Berciano J (1990) Basichondrocranium anomalies in adult Chiari type I malformation: a morphometric study. J Neurol Sci 99:137–145PubMedCrossRef
29.
Welch K, Shillito J, Strand R, Fischer EG, Winston KR (1981) Chiari I “malformations”—an acquired disorder? J Neurosurg 55:604–609PubMedCrossRef
Metadata
Title
Acquired and reversible Chiari-like descent following a single lumbar puncture: case report
Authors
N. Pencovich
L. Ben-Sira
A. Kesler
S. Constantini
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 8/2012
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-012-1738-4

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