Chiari malformation Type I and a dolichoodontoid process responsible for sudden cardiorespiratory arrest. Case report.
The authors present the case of an 11-year-old girl who fell from standing height and experienced sudden cardiorespiratory arrest. A Chiari malformation Type I and a dolichoodontoid process were identified, and a brainstem contusion was found that correlated with the patient's clinical signs and symptoms. The authors hypothesize that the dolichoodontoid in a compromised craniocervical space created a contusion in the apposing brainstem at the time of head impact. The patient was left with permanent vocal cord paresis and spastic quadriparesis. Awareness of this rare occurrence is important in managing these congenital abnormalities and in assessing the risk of deterioration.
Quebada
Patricia B
PB
Section of Neurosurgery, Children's Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
Duhaime
Ann-Christine
AC
D000015:Abnormalities, Multiple; D000058:Accidental Falls; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis; D001930:Brain Injuries / Q000209:etiology; D001933:Brain Stem; D002574:Cervical Vertebrae / Q000601:surgery; D002648:Child; D003399:Craniotomy; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D009809:Odontoid Process / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011782:Quadriplegia / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000209:etiology