A cranio-cervical malformation presenting as acute respiratory failure.
An 18-year-old, previously healthy male presented with bilateral pneumonia and acute respiratory failure with severe carbon dioxide retention. The presence of mild brainstem signs and hypoventilation led to the discovery of a platybasia, basilar invagination, and kinking of the medulla oblongata with early syrinx. He was operated upon but postoperatively was noted to have a mixed type of sleep apnea. This case illustrates the diagnostic challenge in acute respiratory failure in a previously healthy young person and the possible pathogenic mechanisms underlying it.
Ali
M M
MM
Division of Pulmonology, King Fahad National Guard Hospital, Saudi Arabia.
Russell
N
N
Awada
A
A
McLean
D
D
D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000175:diagnosis; D001921:Brain / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010985:Platybasia / Q000150:complications* / Q000175:diagnosis; D012131:Respiratory Insufficiency / Q000209:etiology*