Resolution of tachyarrhythmia following posterior fossa decompression surgery for chiari malformation type I: A case report.

Resolution of tachyarrhythmia following posterior fossa decompression surgery for chiari malformation type I: A case report.

World Neurosurg. 2017 Dec 27;:

Authors: Elia C, Brazdzionis J, Tashjian V

Abstract
INTRODUCTION: Chiari malformation type I (CM) commonly present with symptoms such as tussive headaches, paresthesias and in severe cases, corticobulbar dysfunction.3 However, patients may present with atypical symptoms lending to the complexity in this patient population. We present a case of a CM patient presenting with atypical cardiac symptoms and arrhythmias, all of which resolved after surgical decompression.
CASE DESCRIPTION: A 31-year-old female presented with atypical chest pain, palpitations, tachycardia, headaches, and dizziness for 2 years. Multiple anti-arrhythmics and ultimately cardiac ablation procedure proved to be ineffective. MRI revealed CM and patient ultimately underwent surgical decompression with subsequent resolution of her symptoms.
CONCLUSION: The surgical management of CM patients presenting with atypical symptoms can be challenging and often times leading to delay in intervention. To our knowledge this is the only reported case of a patient presenting with tachyarrhythmia and atypical chest pain with resolution after chiari decompression. We believe the dramatic improvement documented in the present case should serve to advance chiari decompression in CM patients presenting with refractory tachyarrhythmia in whom no other discernable cause has been elucidated. Further studies are needed to better correlate the findings and to hopefully establish a criteria for patients that will likely benefit from surgical decompression.

PMID: 29288861 [PubMed - as supplied by publisher]

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