Symptomatic Chiari type I malformation after radiation therapy in an infant: case report.
OBJECTIVE
One previous case report has described the development of a Chiari I malformation in a child after fractionated radiation therapy to the anterior cranial base. The authors present an additional case of a 17-month-old girl treated for an isolated, malignant, rhabdoid tumor of the right neck with neoadjuvant chemotherapy, surgical exploration, and radiation therapy.


METHODS
The patient developed a Chiari I malformation and cervical syringomyelia 1.5 years after the treatment. The patient experienced two episodes of unresponsiveness before diagnosis, and the malformation was then identified on magnetic resonance imaging scans.


METHODS
Suboccipital decompressive craniectomy, and C1 laminectomy with autologous duraplasty were performed.


RESULTS
Postoperative magnetic resonance imaging scans revealed reconstitution of cerebrospinal fluid at the foramen magnum and ascent of the cerebellar tonsils. The patient remains asymptomatic 5.5 years after treatment.


CONCLUSIONS
The importance of this association is discussed in the context of the increasing use of radiation therapy in young children and infants.
Hoffman
Caitlin E
CE
Department of Neurological Surgery, Weill Medical College of Cornell University, New York, New York 10021, USA.
Lis
Eric
E
Wolden
Suzanne L
SL
Souweidane
Mark M
MM
D001139:Arnold-Chiari Malformation / Q000209:etiology* / Q000601:surgery*; D002526:Cerebellar Diseases / Q000209:etiology / Q000601:surgery*; D002574:Cervical Vertebrae / Q000601:surgery; D003399:Craniotomy; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007223:Infant; D007796:Laminectomy; D011832:Radiation Injuries / Q000209:etiology / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects*; D013595:Syringomyelia / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome