{"id":"1d43ea54-5448-4da7-a2e0-c3e2d05019de","slug":"anesthetic-management-during-cesarean-section-in-a-woman-with-residual-arnold-chiari-malformation-type-i-cervical-kyphosis-and-syringomyelia","title":"Anesthetic management during Cesarean section in a woman with residual Arnold–Chiari malformation Type I, cervical kyphosis, and syringomyelia","authors":["Ramsis F. Ghaly","Kenneth D. Candido","Ruben Sauer","Nebojsa Nick Knezevic"],"abstract":"Background: Arnold–Chiari malformation Type I (ACM) is characterized by the downward displacement of the cerebellar tonsils and medulla through the foramen magnum, often leading to increased cerebrospinal fluid (CSF) pressure during pregnancy. Anesthetic management in parturients with Type I ACM presents unique challenges, particularly concerning CSF pressure fluctuations and airway management. Methods: A 34-year-old woman with a history of Type I ACM, cervical kyphosis, and syringomyelia underwent a Cesarean section. The anesthetic plan included awake fiberoptic intubation and multimodal general anesthesia, with careful monitoring and maintenance of the neck in a neutral position to avoid complications. Results: The patient was successfully intubated using awake fiberoptic techniques, and general anesthesia was maintained without neuromuscular blockade. A healthy baby boy was delivered, and the procedure was completed without incident, with estimated blood loss being less than average. Conclusion: This case highlights the importance of individualized anesthetic management in parturients with residual neurological conditions following surgical treatment for Arnold–Chiari malformation. A multidisciplinary approach is essential to ensure patient safety and optimal outcomes during delivery. Keywords: Arnold-Chiari malformation, syringomyelia, anesthesia, Cesarean section, airway management, cervical kyphosis, pregnancy, general anesthesia","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/1d43ea54-5448-4da7-a2e0-c3e2d05019de/featured/hero-1782420988436.png","publishDate":"2012-02-15T00:00:00.000Z","doi":"10.4103/2152-7806.92940","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/1d43ea54-5448-4da7-a2e0-c3e2d05019de/pdf"}