Spinal neuraxial anaesthesia for caesarean section in a parturient with type I Arnold Chiari malformation and syringomyelia

Abstract

Introduction Type 1 Arnold Chiari malformation is associated with prolapse of the cerebellar tonsils into or below the level of the foramen magnum and is usually diagnosed in adults. There are no current guidelines for the management of patients with a residual type I Arnold Chiari malformation, planned for a caesarean section under spinal neuraxial anaesthesia. The paucity in the literature on this topic presents as a management dilemma. Case report We report a case of a term parturient with type 1 Arnold Chiari malformation, following surgical decompression 4 years earlier, with a residual syringomyelia that underwent an elective caesarean section under spinal neuraxial anaesthesia. Conclusion This case highlights that multidisciplinary management and early anaesthetic consult are of paramount importance in the outcome of the patient, and that spinal neuraxial anaesthesia can be considered as a safe anaesthetic option.