Child's Nervous System

, Volume 23, Issue 8, pp 901–905 | Cite as

Chiari I malformation and intra-cranial hypertension:a case-based review

  • Senta Kurschel
  • Richard Maier
  • Verena Gellner
  • Hans Georg Eder
Case Report

Abstract

Objective

To present clinical and morphological findings before and after surgery in a child with Chairi I malformation (CMI) and intra-cranial hypertension (IH). The literature is reviewed and pathophysiologic factors are discussed.

Clinical presentation

A 13-year-old obese boy with a 3-week history of headaches, neck pain, torticollis and progressive visual deterioration was admitted. Bi-lateral chronic papilloedema and decrease in visual acuity were found in the presence of a previously diagnosed CMI.

Intervention and follow-up

Intra-cranial pressure monitoring demonstrating increased pressure levels was followed by a sub-occipital decompression, C1 laminectomy and duroplasty. Post-operatively, the boy improved markedly, the 6 months follow-up opthalmological examination demonstrated resolution of papilloedema, but consecutive bi-lateral optic nerve atrophy.

Conclusion

IH with progressive visual deterioration represents one of the varying clinical presentations of CMI and may be classified as a secondary form of idiopathic IH. Neuro-ophthalmological examination in all patients with CMI is recommended to identify the real incidence of this presentation. Altered CSF dynamics, venous hypertension and obesity as co-factors may be causative pathophysiologic factors.

Keywords

Chiari I malformation Intra-cranial hypertension Papilloedema Paediatric 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Senta Kurschel
    • 1
  • Richard Maier
    • 2
  • Verena Gellner
    • 1
  • Hans Georg Eder
    • 1
  1. 1.Department of NeurosurgeryMedical UniversityGrazAustria
  2. 2.Department of OphthalmologyMedical UniversityGrazAustria

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