title: Chiari malformation and sleep-disordered breathing: a review of diagnostic and management issues.
abstract: Chiari Malformation (CM) encompasses several patterns of congenital or acquired cerebellar herniation through the foramen magnum. This may result in brain-stem compression that impacts control of breathing and is associated with obstructive and central apneas. A high clinical suspicion for sleep-disordered breathing is needed in the care of such patients after as well as before corrective surgery. To introduce a review of CM with a focus on the relevance to sleep medicine, we present a case of a 13-year-old female who was diagnosed with CM Type 1 in the course of an evaluation of symptomatic central sleep apnea. After initial improvement following surgery there was recurrence of brain-stem compression. The only clinical expression of which was polysomnographically evident recurrence of sleep apnea.
authors.affiliation: Division of Pulmonary, Allergy Critical Care and Sleep Medicine, University of Pittsburgh School of Medicine, PA 15213, USA.
authors.forename: P
authors.initials: P
authors.lastname: Zolty
authors.forename: M H
authors.initials: MH
authors.lastname: Sanders
authors.forename: I F
authors.initials: IF
authors.lastname: Pollack
mesh_terms: D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D001933:Brain Stem / Q000473:pathology; D019299:Decompression, Surgical; D004677:Encephalocele / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures; D017286:Polysomnography; D012008:Recurrence; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology