Indian Journal of Anaesthesia  
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CASE REPORT
Year : 2012  |  Volume : 56  |  Issue : 6  |  Page : 579-581

Presentation of occult Chiari I malformation following spinal anesthesia


Department of Anesthesia, Toronto Western Hospital, 399 Bathurst Street, MCL 2-405, Toronto, Ontario, M5T 2S8, Canada

Correspondence Address:
Lashmi Venkatraghavan
Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst Street, McL 2-405, Toronto, ON, M5T 2S8
Canada
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Source of Support: Department of Anesthesia, Toronto Western Hospital, University Health Network, Toronto, Canada, Conflict of Interest: None


DOI: 10.4103/0019-5049.104583

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Chiari I malformation (CM-I) manifests with tonsillar herniation below foramen magnum. These patients are at high risk of respiratory depression and bulbar dysfunction in the perioperative period with underlying obstructive sleep apnea. However, the safe use of both general and regional anaesthesia has been documented in a known CM-I parturients. We describe the successful management of a patient who had hypercapnic respiratory failure in the post-anaesthetic care unit following an uneventful subarachnoid block for left knee replacement surgery. This patient was retrospectively diagnosed with occult CM-I and moderate to severe obstructive sleep apnea in the postoperative period.


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