Abstract:

Chiari malformation was described and published by Hans Chiari in 1891 as displacement of posterior fossa content into spinal canal. It was republished as Arnold-Chiari malformation (ACM) as Arnold reported a child with meningomyelocele accompanied by hindbrain herniation. In the etiopathogenesis, the most widely accepted theory is presence of a mesodermal defect in craniovertebral junction. ACM classified into 4 types. In the most common form, namely type 1, cerebellar tonsils are displaced more than 4 mm from foramen magnum to cervical spinal cord. Generally, it is failed to recognize until adolescent age or adulthood when it causes problem. In ACM type II, it is condition in which brainstem, fourth ventricle and cerebellum enter spinal cord; pons and fourth ventricle is shifted. Sonography and magnetic resonance imaging in infants can be readily available for diagnostic purposes without ionizing radiation. In ACM type II, the aim of surgical treatment is correction of comorbid pathologies associated with clinical improvement. V-P shunt insertion is the first-line intervention in case of comorbid hydrocephaly. Then, meningomyelocele should be repaired. In the present study, a case with Arnold-Chiari malformation type II causing bilateral vocal cord paralysis is discussed in the light of literature

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