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Improvement of obstructive sleep apneas caused by hydrocephalus associated with Chiari malformation Type II following surgery.
J Neurosurg Pediatr. 2010 Oct; 6(4):336-9.JN

Abstract

Chiari malformation (CM) is the downward herniation of the caudal part of the cerebellum and/or medulla oblongata into the spinal canal. It can alter several neurological functions, including respiratory control and upper airway motility, and can be the cause of sleep-disordered breathing (SDB). The authors describe a 6-year-old boy affected by CM Type II associated with myelomeningocele who showed symptoms indicative of severe airway obstruction during sleep. Polysomnography revealed severe obstructive sleep apnea syndrome (OSAS). Magnetic resonance imaging demonstrated herniation of the cerebellar tonsils and diffuse ventricular dilation with a large pseudocystic formation in the third ventricle. Surgical marsupialization of the cystic wall was performed, associated with ventriculocystostomy and endoscopic replacement of the ventricular catheter. Polysomnography repeated 2 months after surgery revealed a striking improvement in the sleep-related respiratory pattern. The pathogenesis of OSAS was probably referable to a combination of CM and elevated intracranial pressure. However, the striking improvement of symptoms after ventriculoatrial shunt placement suggested that hydrocephalus plays a major role in this condition. Assessment and effective treatment of SDB is crucial in the care of patients with CM.

Authors+Show Affiliations

Department of Neurosciences, Catholic University of Sacred Heart, Rome, Italy. mluigetti@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20887105

Citation

Luigetti, Marco, et al. "Improvement of Obstructive Sleep Apneas Caused By Hydrocephalus Associated With Chiari Malformation Type II Following Surgery." Journal of Neurosurgery. Pediatrics, vol. 6, no. 4, 2010, pp. 336-9.
Luigetti M, Losurdo A, Dittoni S, et al. Improvement of obstructive sleep apneas caused by hydrocephalus associated with Chiari malformation Type II following surgery. J Neurosurg Pediatr. 2010;6(4):336-9.
Luigetti, M., Losurdo, A., Dittoni, S., Testani, E., Colicchio, S., Gnoni, V., Farina, B., Scarano, E., Zampino, G., Mariotti, P., Rendeli, C., Di Rocco, C., Massimi, L., & Della Marca, G. (2010). Improvement of obstructive sleep apneas caused by hydrocephalus associated with Chiari malformation Type II following surgery. Journal of Neurosurgery. Pediatrics, 6(4), 336-9. https://doi.org/10.3171/2010.7.PEDS10207
Luigetti M, et al. Improvement of Obstructive Sleep Apneas Caused By Hydrocephalus Associated With Chiari Malformation Type II Following Surgery. J Neurosurg Pediatr. 2010;6(4):336-9. PubMed PMID: 20887105.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvement of obstructive sleep apneas caused by hydrocephalus associated with Chiari malformation Type II following surgery. AU - Luigetti,Marco, AU - Losurdo,Anna, AU - Dittoni,Serena, AU - Testani,Elisa, AU - Colicchio,Salvatore, AU - Gnoni,Valentina, AU - Farina,Benedetto, AU - Scarano,Emanuele, AU - Zampino,Giuseppe, AU - Mariotti,Paolo, AU - Rendeli,Claudia, AU - Di Rocco,Concezio, AU - Massimi,Luca, AU - Della Marca,Giacomo, PY - 2010/10/5/entrez PY - 2010/10/5/pubmed PY - 2010/10/26/medline SP - 336 EP - 9 JF - Journal of neurosurgery. Pediatrics JO - J Neurosurg Pediatr VL - 6 IS - 4 N2 - Chiari malformation (CM) is the downward herniation of the caudal part of the cerebellum and/or medulla oblongata into the spinal canal. It can alter several neurological functions, including respiratory control and upper airway motility, and can be the cause of sleep-disordered breathing (SDB). The authors describe a 6-year-old boy affected by CM Type II associated with myelomeningocele who showed symptoms indicative of severe airway obstruction during sleep. Polysomnography revealed severe obstructive sleep apnea syndrome (OSAS). Magnetic resonance imaging demonstrated herniation of the cerebellar tonsils and diffuse ventricular dilation with a large pseudocystic formation in the third ventricle. Surgical marsupialization of the cystic wall was performed, associated with ventriculocystostomy and endoscopic replacement of the ventricular catheter. Polysomnography repeated 2 months after surgery revealed a striking improvement in the sleep-related respiratory pattern. The pathogenesis of OSAS was probably referable to a combination of CM and elevated intracranial pressure. However, the striking improvement of symptoms after ventriculoatrial shunt placement suggested that hydrocephalus plays a major role in this condition. Assessment and effective treatment of SDB is crucial in the care of patients with CM. SN - 1933-0715 UR - https://www.unboundmedicine.com/medline/citation/20887105/Improvement_of_obstructive_sleep_apneas_caused_by_hydrocephalus_associated_with_Chiari_malformation_Type_II_following_surgery_ L2 - https://thejns.org/doi/10.3171/2010.7.PEDS10207 DB - PRIME DP - Unbound Medicine ER -