Acute spinal cord swelling in a child with Chiari II malformation

We report on a patient with Chiari II malformation who developed acute cerv ical myelopathy and brainstem dysfunction following a shunt failure. A brai n and spine magnetic resonance image obtained immediately after admission e videnced swelling of the medulla and upper cervical spinal cord. After emer gency placement of an external ventricular drain, the swelling receded, the child's respiratory pattern improved and the motor function of his upper a nd lower extremities progressively returned to its normal condition. The ca se reported here suggests that in patients with Chiari type II malformation , spinal cord swelling might have a similar pathophysiology to the perivent ricular edema observed in the supratentorial compartment, and thus may be i ndependent of the early stages of syringomyelia or syringobulbia. Copyright (C) 2001 S. Karger AG, Basel.