ARNOLD-CHIARI MALFORMATION ASSOCIATED WITH SLEEP-APNEA AND CENTRAL DYSREGULATION OF ARTERIAL-PRESSURE

The natural history of symptomatic adult type I Arnold-Chiari (ACM1) m alformation is variable. Patients with this condition frequently devel op corticospinal and sensory deficits, together with cerebellar signs and lower cranial nerve palsies in various combinations. In the presen t report we describe a patient with ACM1 in whom sleep apnea together with disturbances in the central regulation of arterial pressure were a major component of the symptomatology. These paroxysmal blood pressu re changes has not been previously reported. The decompression of our patient's medulla, which contains the primary respiratory centers and baroreceptors, resulted in a marked improvement and indicate that the origin may have been on a central basis.