Chiari malformation presenting with subarachnoid hemorrhage: a case report

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Abstract

Chiari malformations (CM) are often diagnosed in childhood and younger adults, with an incidence of only 0.77% in adult populations. Patients with CM may develop syringomyelia and increased intracranial pressure (ICP) due to cerebrospinal fluid (CSF) obstruction and altered fluid dynamics at the cervicomedullary junction. We describe the case of a 65-year-old female presenting with an angionegative subarachnoid hemorrhage (SAH) with concomitant new diagnosis of CM type I with syringomyelia. After ruling out any aneurysm or vascular malformations, she underwent a suboccipital craniectomy for a Chiari decompression with a C1 laminectomy. There were no complications with the surgery and her symptoms improved. This case report highlights the unusual presentation of a CM.
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Chiari畸形伴蛛网膜下腔出血:病例报告。
恰里畸形(Chiari malformations,CM)通常在儿童和青少年时期被诊断出来,在成年人群中的发病率仅为 0.77%。由于颈髓交界处的脑脊液(CSF)阻塞和流体动力学改变,CM 患者可能会出现鞘膜积液和颅内压(ICP)升高。我们描述了一例 65 岁女性蛛网膜下腔出血(SAH)患者的病例,该患者被诊断为Ⅰ型鞘膜积液。在排除了动脉瘤或血管畸形的可能性后,她接受了枕骨下颅骨切除术,以进行Chiari减压术和C1椎板切除术。手术没有出现并发症,她的症状也得到了改善。本病例报告强调了奇异畸形的不寻常表现。恰里畸形(Chiari malformations,CM)通常在儿童和青少年中确诊,在成人中的发病率仅为 0.77%。有时,CM 患者会因脑脊液阻塞和颅颈交界处流体动力学改变而出现鞘膜积液和颅内高压。我们描述了一例 65 岁女性的病例,她因蛛网膜下腔出血就诊,但血管造影并未显示出血,新诊断为 CM 1 并伴有鞘膜积液。在排除了动脉瘤或血管畸形的可能性后,我们对她进行了枕骨下开颅手术,进行了奇拉氏减压术和 C1 椎板切除术。手术后没有出现其他并发症,她的症状也得到了改善。该临床病例突出显示了脊髓灰质炎的异常表现。
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