Chiari malformation presenting with subarachnoid hemorrhage: a case report

Neurocirugia (Astur : Engl Ed). 2024 Nov-Dec;35(6):319-322. doi: 10.1016/j.neucie.2024.06.002. Epub 2024 Jun 27.

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.

Keywords: C1 laminectomy; Chiari malformation; Hemorragia subaracnoideo; Laminectomía de C1; Malformación de Chiari; Subarachnoid hemorrhage; Syrinx.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arnold-Chiari Malformation* / complications
  • Arnold-Chiari Malformation* / surgery
  • Decompression, Surgical
  • Decompressive Craniectomy
  • Female
  • Humans
  • Laminectomy
  • Magnetic Resonance Imaging
  • Subarachnoid Hemorrhage* / complications
  • Subarachnoid Hemorrhage* / diagnostic imaging
  • Subarachnoid Hemorrhage* / etiology
  • Subarachnoid Hemorrhage* / surgery
  • Syringomyelia* / complications
  • Syringomyelia* / diagnostic imaging
  • Syringomyelia* / surgery