title: Acquired Chiari I malformation following baclofen pump placement in a child. Case report.
abstract: The authors present a case of a child suffering from shunt-treated hydrocephalus and spastic quadriplegia who underwent surgery for placement of a baclofen pump. Magnetic resonance (MR) imaging performed prior to pump placement demonstrated no hindbrain herniation. Afterward, however, the patient exhibited symptoms of brainstem compression, and MR imaging revealed a significant Chiari I malformation along with a fully functioning ventriculoperitoneal shunt. Posterior fossa decompression was performed, and the patient's symptoms abated. The authors believe this to be the first report of an acquired Chiari I malformation in a patient with a baclofen pump. Clinicians should consider Chiari I malformation as a rare but severe complication of baclofen pump placement.
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Children's Hospital, Birmingham, Alabama 35233, USA. richard.tubbs@ccc.uab.edu
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Charles
authors.initials: C
authors.lastname: Law
authors.forename: W Jerry
authors.initials: WJ
authors.lastname: Oakes
authors.forename: Paul A
authors.initials: PA
authors.lastname: Grabb
mesh_terms: D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001418:Baclofen / Q000008:administration & dosage / Q000009:adverse effects*; D019299:Decompression, Surgical; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000601:surgery; D015918:Infusion Pumps, Implantable; D007263:Infusions, Parenteral; D008279:Magnetic Resonance Imaging; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000009:adverse effects*; D019635:Neurosurgical Procedures; D011782:Quadriplegia / Q000150:complications / Q000188:drug therapy*; D013115:Spinal Canal; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen