Öz
The Arnold-Chiari I malformation (ACM) is a congenital anomaly characterized by downward herniation of the cerebellar tonsils into the spinal canal. The anomaly may present in a variety of ways with vague symptoms such as head and limb pains, vertigo, hypoesthesia, weakness in the extremities. Diagnosis is often difficult and therefore delayed. Measurement of intracranial pressure in these patients is an important measure thus precautions shoul be taken for avoidance of increased intracranial pressure. In this case report, we discussed the anesthetic management of a pregnant patient with Arnold Chiari I malformation who underwent an emergency caesarean section.
Anahtar Kelimeler
Kaynakça
- Bejjani GK. Definition of the adult Chiari malformation: a brief historical overview. Neurosurg Focus 2001;11(1):1-8.
- Chantigian RC, Koehn MA, Ramin KD, Warner MA. Chiari I malformation in parturients. J Clin Anesth 2002; 14(3):201-5.
- Penney DJ, Smallman JM. Arnold Chiari malformation and pregnancy. Int J Obstet Anesth 2001;10(2):139-41.
- Rewari V, Singh S, Trikha A. Laparoscopic cholecystectomy in a morbidly obese patient with Chiari I malformation and craniocervical anomalies. J Clin Anesth 2008; 20(5):372-5.
- Elster AD, Chen MY. Chiari I malformation: clinical and ra- diologic reappraisal. Radiology 1992; 183(2):347-53.
- Landau R, Giraud R, Delrue V, Kern C. Spinal anesthesia for cesarean delivery in a woman with a surgically cor- rected type I Arnold Chiari malformation. Anesth Analg 2003;97(1):253-5.
- Agustí M, Adàlia R, Fernández C, Gomar C. Anaesthesia for caesarean section in a patient with syringomyelia and Ar- nold-Chiari type I malformation. Int J Obstet Anesth 2004; 13(2):114-6.
- Murayama K, Mamiya K, Nozaki K et al. Cesarean section in a patient with syringomyelia. Can J Anaesth 2001; 48 (5):474-7.
- Chantigian RC, Koehn MA, Ramin KD, Warner MA. Chiari I malformation in parturients. J Clin Anesth 2002; 14(3):201- 5.
- Çelik F, Tüfek A, Yıldırım ZB, et al. İleri derece yaşlı has- tada mini doz bupivakain ile spinal anestezi. J Clin Exp In- vest 2010;1 (3); 214-5.
- Nel M R, Robson V, Robinson PN. Extradural anaesthesia for caesarean section in a patient with syringomyelia and Chiari type I anomaly. Br J Anaesth 1998; 80(4):512-5.
Öz
Arnold-Chiari I malformasyonu (ACM), serebellar tonsillerin aşağıya, spinal kanala doğru herniyasyonu ile karakterize konjenital bir anomalidir. Anomali kendini, baş ve ekstremite ağrıları, vertigo, hipoestezi, ekstremitelerde güçsüzlük gibi silik ve değişik belirtilerle gösterebilir. Tanı genellikle güçtür ve bundan dolayı gecikmiştir. Bu hastalarda intrakranial basınç önemli olup basıncın korunması yönünde tedbir alınmalıdır. Bu olgu sunumunda acil sezeryan operasyonu planlanan Arnold-Chiari I malformasyonlu gebede anestezi yönetimini tartıştık.
Anahtar Kelimeler
Kaynakça
- Bejjani GK. Definition of the adult Chiari malformation: a brief historical overview. Neurosurg Focus 2001;11(1):1-8.
- Chantigian RC, Koehn MA, Ramin KD, Warner MA. Chiari I malformation in parturients. J Clin Anesth 2002; 14(3):201-5.
- Penney DJ, Smallman JM. Arnold Chiari malformation and pregnancy. Int J Obstet Anesth 2001;10(2):139-41.
- Rewari V, Singh S, Trikha A. Laparoscopic cholecystectomy in a morbidly obese patient with Chiari I malformation and craniocervical anomalies. J Clin Anesth 2008; 20(5):372-5.
- Elster AD, Chen MY. Chiari I malformation: clinical and ra- diologic reappraisal. Radiology 1992; 183(2):347-53.
- Landau R, Giraud R, Delrue V, Kern C. Spinal anesthesia for cesarean delivery in a woman with a surgically cor- rected type I Arnold Chiari malformation. Anesth Analg 2003;97(1):253-5.
- Agustí M, Adàlia R, Fernández C, Gomar C. Anaesthesia for caesarean section in a patient with syringomyelia and Ar- nold-Chiari type I malformation. Int J Obstet Anesth 2004; 13(2):114-6.
- Murayama K, Mamiya K, Nozaki K et al. Cesarean section in a patient with syringomyelia. Can J Anaesth 2001; 48 (5):474-7.
- Chantigian RC, Koehn MA, Ramin KD, Warner MA. Chiari I malformation in parturients. J Clin Anesth 2002; 14(3):201- 5.
- Çelik F, Tüfek A, Yıldırım ZB, et al. İleri derece yaşlı has- tada mini doz bupivakain ile spinal anestezi. J Clin Exp In- vest 2010;1 (3); 214-5.
- Nel M R, Robson V, Robinson PN. Extradural anaesthesia for caesarean section in a patient with syringomyelia and Chiari type I anomaly. Br J Anaesth 1998; 80(4):512-5.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2012 |
| Gönderilme Tarihi | 2 Mart 2015 |
| Yayımlandığı Sayı | Yıl 2012 Cilt: 39 Sayı: 2 |