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Tytuł:
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Determinants of Chiari I progression in pregnancy.
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Autorzy:
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Janjua MB; Department of Neurological Surgery, Mercy Health Hospital, Rockford, IL, USA. Electronic address: .
Haynie AE; Department of Neurology, Mercy Health Hospital, Rockford, IL, USA.
Bansal V; Department of Neurology, Mercy Health Hospital, Rockford, IL, USA. Electronic address: .
Bhattacharia S; Department of Obstetrics and Gynaecology, Mercy Health Hospital, Rockford, IL, USA.
Grant T; Department of Anesthesiology, Mercy Health Hospital, Rockford, IL, USA.
McQuillan D; Department of Anesthesiology, Mercy Health Hospital, Rockford, IL, USA.
Passias PG; Department of Orthopedic Surgery, NYU Langone Medical Center, New York, NY, USA.
Ozturk AK; Department of Neurosurgery, University of Pennsylvania Hospital, PA, USA.
Hwang SW; Department of Pediatric Neurosurgery, Shriners Hospital for Children Philadelphia, PA, USA.
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Źródło:
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Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2020 Jul; Vol. 77, pp. 1-7. Date of Electronic Publication: 2020 May 07.
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Typ publikacji:
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Case Reports; Journal Article; Review
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Język:
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English
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Imprint Name(s):
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Publication: <2000->: Edinburgh : Churchill Livingstone
Original Publication: Melbourne, Vic., Australia : Churchill Livingstone, c1994-
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MeSH Terms:
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Disease Progression*
Arnold-Chiari Malformation/*diagnostic imaging
Pregnancy Complications/*diagnostic imaging
Adult ; Arnold-Chiari Malformation/complications ; Arnold-Chiari Malformation/therapy ; Cough/complications ; Cough/diagnostic imaging ; Cough/therapy ; Delivery, Obstetric/methods ; Female ; Foramen Magnum/diagnostic imaging ; Headache Disorders, Primary/complications ; Headache Disorders, Primary/diagnostic imaging ; Headache Disorders, Primary/therapy ; Humans ; Magnetic Resonance Imaging/methods ; Pregnancy ; Pregnancy Complications/therapy ; Risk Factors
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Contributed Indexing:
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Keywords: C-section; Chiari malformation type I; Mode of anesthesia and delivery; Neuroaxial analgesia; Pregnancy
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Entry Date(s):
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Date Created: 20200517 Date Completed: 20201015 Latest Revision: 20210611
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Update Code:
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20240105
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DOI:
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10.1016/j.jocn.2020.05.026
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PMID:
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32414621
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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 pre-conception, 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.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
Comment in: J Clin Neurosci. 2021 Jan;83:153-154. (PMID: 33317880)
