Anesthetic Considerations in A Case of Arnold Chairi Malformation Type II

Abstract

Arnold chiari malformation (ACM) Type II is a developmental abnormality of the brainstem and cerebellar tonsil, medulla and protrusion of 4 th ventricle into cervical spinal canal. To best of our knowledge, there is paucity of literature regarding anesthetic management of cases with ACM type II. The anesthetic concerns with general anesthesia are related to the risk of autonomic dysfunction, difficult airway management, damage to the spinal cord and sensitivity to neuromuscular blocking agents. There is risk of increasing intracranial pressure and brainstem compression or herniation leading to hemodynamic and respiratory compromise, due to presence of meningomyelocoele, syringohydromyelia and tethered spinal cord.