Am J Perinatol 2005; 22(2): 67-70
DOI: 10.1055/s-2005-837271
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Chiari I Malformation with or without Syringomyelia and Pregnancy: Case Studies and Review of the Literature

Diane M. Mueller1 , John Oro'1
  • 1Division of Neurosurgery, University Health Care, Columbia, Missouri
Further Information

Publication History

Publication Date:
24 February 2005 (online)

ABSTRACT

Women with Chiari I malformation with or without syringomyelia are of particular concern because of the potential risk of increased intracranial pressure during pregnancy and delivery. The following questions are most often asked in the clinical setting: Is it safe to have a planned pregnancy? Will the symptoms become worse or recur during pregnancy and will the baby be normal? Seven patients with Chiari I malformation, with and without syringomyelia, submitted checklists of self-reported symptoms experienced during pregnancy, labor, and postpartum. Seven patients with Chiari I malformation with and without syringomyelia were queried for symptoms during pregnancy, labor, and postpartum. None of the patients reported significant increase or recurrence of Chiari-related symptoms during delivery or postpartum. Four of the women had epidural anesthesia for delivery and reported no related symptoms. This series represents a small number of women with Chiari I malformation who had uncomplicated pregnancy, labor, and delivery.

REFERENCES

  • 1 Anson J A, Benzel E C, Awad I A. Syringomyelia and the CMIs. Neurosurgical Topics Park Ridge, IL; The American Association of Neurological Surgeons 1997
  • 2 Bejjani G K. Definition of the adult CMI: a brief historical overview.  Neurosurg Focus. 2001;  11 1-8
  • 3 Milhorat T H, Chou M W, Trinidat E M et al.. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients.  Neurosurgery. 1999;  44 1005-1007
  • 4 Mueller D M, Oro' J J. Prospective analysis of presenting symptoms among 265 patients with radiographic evidence of CMI with or without syringomyelia.  J Am Acad Nurse Pract. 2004;  16 134-138
  • 5 Nash J, Cheng J S, Meyer G A, Remler B F. Chiari type I malformation: overview of diagnosis and treatment.  WMJ. 2002;  101 35-40
  • 6 Aldern T D, Ojemann J G, Park T S. Surgical treatment of Chiari I malformation: indications and approaches.  Neurosurg Focus. 2001;  11 1-5
  • 7 Guyotat J, Bret P, Jouanneau E, Ricci A C, Lapras C. Syringomyelia associated with Type I CMI: a 21 year retrospective study on 75 cases treated by foramen magnum decompression with a special emphasis on the value of tonsil resection.  Acta Neurochir (Wien). 1998;  140 745-754
  • 8 Heiss J D, Patronas N, DeVroom H L et al.. Elucidating the pathophysiology of syringomyelia.  J Neurosurg. 1999;  91 553-562
  • 9 Hopkins E L, Hendricks C H, Cibils L A. Cerebrospinal fluid pressure in labor.  Am J Obstet Gynecol. 1965;  93 907-916
  • 10 Marx G F, Oka Y, Orkin L R. Cerebrospinal fluid pressures during labor.  Am J Obstet Gynecol. 1962;  84 213-219
  • 11 Vasicka A, Kretchmer H, Lawas F. Cerebrospinal fluid pressures during labor.  Am J Obstet Gynecol. 1962;  84 206-212
  • 12 O'Reilly S A, Toffol G J. Adult Arnold-CMI: a postpartum case presentation.  J Am Osteopath Assoc. 1995;  95 607-609
  • 13 Semple D A, McClure J H, Wallace E M. Arnold-CMI in pregnancy.  Anaesthesia. 1996;  51 580-582
  • 14 Nel M R, Robson V, Robinson P N. Extradural anesthesia for caesarean section in a patient with syringomyelia and Chiari type I anomaly.  Br J Anaesth. 1998;  80 512-515
  • 15 Murayama K, Mamiya K, Nozaki K et al.. Cesarean section in a patient with syringomyelia.  Can J Anaesth. 2001;  48 474-477
  • 16 Parker J D, Broberg J C, Napolitano P G. Maternal Arnold-Chiari type I malformation and syringomyelia: a labor management dilemma.  Am J Perinatol. 2002;  19(8) 445-449
  • 17 Chantigian R C, Koehn M A, Ramin K D, Warner M A. Chiari I malformation in parturients.  J Clin Anesth. 2002;  14 201-205

Diane M MuellerN.D. R.N. 

Division of Neurosurgery-N 521, University Health Care

1 Hospital Drive, Columbia, MO 65212

    >