Chiari malformation unmasked by accidental dural puncture

Puissant, Lynn; Deckers, J.; Soetens, Filiep

doi:10.1097/eja.0000000000000097

Cited by 2 publications

(7 citation statements)

References 12 publications

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“…New mothers are advised to get plenty of rest, maintain healthy diets, refrain from strenuous activities, and seek medical attention when warranted [22]. CM-I mothers are additionally asked to refrain from sneezing, coughing, bending, and lifting heavy objects as these maneuvers can worsen CM-I symptoms [4,23].…”

Section: Postpartum Carementioning

confidence: 99%

“…Literature reports postpartum CM-I symptoms are specific to mode of delivery and anesthetic technique employed. A common side effect reported following lumbar puncture is the Postdural Puncture Headaches (PDPH) [17,23]. PDPH are postural headaches that worsen when upright and improve when lying down [23].…”

Section: Postpartum Carementioning

confidence: 99%

“…A common side effect reported following lumbar puncture is the Postdural Puncture Headaches (PDPH) [17,23]. PDPH are postural headaches that worsen when upright and improve when lying down [23]. PDPH treatment often involves treatment with an epidural blood patch [17].…”

Section: Postpartum Carementioning

confidence: 99%

“…PDPH, are not the only postpartum CM-I headaches. Puissant et al [23] reiterate that not all headaches after dural puncture are categorized as PDPH. Some headaches are associated with neck pain, stiffness, nausea, and diplopia [10,23].…”

Section: Postpartum Carementioning

confidence: 99%

“…Puissant et al [23] reiterate that not all headaches after dural puncture are categorized as PDPH. Some headaches are associated with neck pain, stiffness, nausea, and diplopia [10,23]. Postpartum treatment of CM-I depend on the severity of these symptoms.…”

Section: Postpartum Carementioning

confidence: 99%

See 4 more Smart Citations

Determinants of Chiari I progression in pregnancy

Janjua

Haynie

Bansal

et al. 2020

Journal of Clinical Neuroscience

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Chiari Malformation type 1 (CM-I) is congenital or an acquired anomaly of the hind brain; develops when the cerebellar tonsils recede downwards below the foramen magnum. Recurrent post tussive suboccipital headache is the common presentation in a pregnant woman and the diagnosis is usually missed or delayed due to lack of formal understanding of this neurological pathology. Much has been written regarding presentation, morphology and the treatment of CM-I; however, little is known when the etiology is acquired or an iatrogenic in its evolution. Similarly, unknown is the progression of CM-I (diagnosed or undiagnosed) in pregnancy. The objective of this study is to elucidate the causes of progression of CM-I in pregnancy, and how this can be avoided. A detailed literature review has been conducted to find the case reports or case studies on association of CM-I in pregnancy; therefore, the risk factors regarding the progression have been sought. There is a lack of literature on timing, mode of anesthesia, and the management of CM-I. Moreover, authors have sought a questionnaire to screen these patients at preconception, intrapartum visits if, the initial diagnosis is delayed. Crucial points of concern including but not limited to the diagnosis, pre-conception counseling, timing of intervention during pregnancy, and mode of anesthesia, have been discussed in detail. In summary, a formal management algorithm has been proposed to avoid the rapid progression of this complex neurological pathology especially, in women of child bearing age and/or during pregnancy.

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Section: Postpartum Carementioning

confidence: 99%