Anesthetic Options for the Parturient With a Neural Tube Defect

Spinal anesthesia for a parturient with the triad of Currarino

“…In one patient the cerebrospinal fluid pressure gradient was increased and in two others a syrinx was observed. In patients with an Arnold Chiari type I malformation only, several complications have been reported after neuraxial anesthesia, [12][13][14] including post dural puncture headaches and nystagmus after spinal anesthesia. Patients with symptoms suggestive of increased intracranial pressure should have a cranial neurologic and radiologic examination; if intracranial pressure is increased, neuraxial techniques are best avoided.…”

Anesthetic management in a patient with Arnold‐Chiari malformation type 1,5: A case report

“…6 On the other side, if intracerebral pressure above the level of the foramen magnum is sufficiently high, the negative spinal pressure that potentially could result during the performance of spinal anesthesia (SA) could cause further cerebellar tonsillar herniation and CSF outflow obstruction at the level of the foramen magnum, resulting in subsequent neurologic deterioration. 7 We believe to provide an interesting point of view since the anesthesiological scientific literature on this type of patient is still quite sparse today.…”

A Case Report of Fluoroscopically Guided Epidural Catheter Placement in a Parturient with History of Tethered Cord, Super-Morbid Obesity, and Risk for Difficult Airway

“…This anatomic restriction of normal spinal cord movement is associated with urinary incontinence, lower extremity weakness, gait abnormalities, spasticity, sensory changes, scoliosis, and lumbar back pain. 1,2 Tethered cord syndrome occurs in approximately 3.9 per 10,000 live births. 2,3 Untethering surgery is performed early in childhood; patients may not regain full mobility of the conus medullaris within the intrathecal space, and asymptomatic postsurgical retethering is not uncommon.…”

“…This anatomic restriction of normal spinal cord movement is associated with urinary incontinence, lower extremity weakness, gait abnormalities, spasticity, sensory changes, scoliosis, and lumbar back pain. 1,2 Tethered cord syndrome occurs in approximately 3.9 per 10,000 live births. 2,3…”