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Arnold-Chiari Malformation in a Pregnant Woman

Sicuranza, Genevieve B. MD; Steinberg, Paul MD; Figueroa, Reinaldo MD

Case Reports

BACKGROUND The Arnold-Chiari malformation type I is characterized by the prolapse of the cerebellar tonsils below the foramen magnum. There is a lack of literature on the management of a pregnancy in a woman affected by an Arnold-Chiari malformation.

CASE A young primipara with severe headaches underwent an elective primary cesarean delivery under general anesthesia successfully. Five years earlier, she had undergone neurosurgical resection for filum terminale syndrome shortly after her first pregnancy (term vaginal delivery) and decompression of a type I Arnold-Chiari malformation 4 months later.

CONCLUSION Careful selection of anesthetic technique for the delivery of a woman with an Arnold-Chiari malformation is of paramount importance.

Departments of Obstetrics and Gynecology and Anesthesiology, Winthrop-University Hospital, Mineola, New York

Address reprint requests to: Reinaldo Figueroa, MD, State University of New York at Stony Brook, Department of Obstetrics, Gynecology and Reproductive Medicine, Health Sciences Center T9-030, Stony Brook, NY 11794-8091; E-mail: rfigueroa@notes.cc.sunysb.edu.

Received October 3, 2002. Received in revised form January 28, 2003. Accepted January 30, 2003.

© 2003 The American College of Obstetricians and Gynecologists