Chiari I Malformation with Acute Brain Stem Compression Syndromes Requiring Emergency Neurosurgical Intervention: Report of Two Cases

Abstract

While Chiari I malformation is a relatively common finding on MRI imaging, the vast majority of patients are asymptomatic and those who do present typically follow a slow course of chronic or subacute progression of symptoms. Emergent deterioration of existing Chiari malformation is rare. We present two patients with previously undiagnosed Chiari I malformation presenting with acute deterioration, one as a result of trauma and the other due to meningitis. Both of the patients required emergent surgical intervention, and each experienced recovery by postoperative month three. We present these two cases and review the pertinent literature.