Abstract
Arnold-Chiari malformations (ACM) are a group of congenital disorders defined by downward displacement of cerebellar tonsils, and possibly the brainstem, through the foramen magnum. Type 1 ACM is the most frequent of the Chiari malformations and is characterized by a ≥5 mm tonsillar descent below the foramen magnum. Headache is the most common presenting symptom, however many patients are asymptomatic. This congenital anatomic variation can lead to potentially challenging obstetric and anesthetic implications during pregnancy and delivery, such as a greater risk for increased intracranial pressure. Although literature discussing ACM management in pregnancy and delivery is scarce and controversial, both neuraxial and general anesthetic techniques have been described safely. However, neither technique is without significant potential risk. The delivery and anesthetic plan for each parturient with ACM must be formulated individually at a multidisciplinary center utilizing a team approach with the patient, obstetrician, anesthesiologist and neurosurgeon.
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Maxwell, M. (2018). Arnold-Chiari Malformation. In: Mankowitz, S. (eds) Consults in Obstetric Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-59680-8_13
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DOI: https://doi.org/10.1007/978-3-319-59680-8_13
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