Indian Journal of Critical Care Medicine

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VOLUME 21 , ISSUE 10 ( 2017 ) > List of Articles

CASE REPORT

Hypercapnic respiratory failure in case of chiari 1.5 malformation: Case Report and review of the literature

Viralkumar Vasani, Subhas Konar, S. Satish

Keywords : Chiari 1.5 malformation, hypercapnic respiratory failure, outcome, radiology, syringomyelia

Citation Information : Vasani V, Konar S, Satish S. Hypercapnic respiratory failure in case of chiari 1.5 malformation: Case Report and review of the literature. Indian J Crit Care Med 2017; 21 (10):707-709.

DOI: 10.4103/ijccm.IJCCM_179_17

License: CC BY-ND 3.0

Published Online: 00-10-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Type 2 respiratory failure is defined as hypercapnia associated with hypoxia. Chiari 1.5 is known as herniation of the cerebellar tonsils along with brain stem and fourth ventricle. We report a 35-year-old male who presented with acute hypercapnic respiratory failure (Type 2), without any preexisting neurological or respiratory abnormality. Analysis of blood gases in emergency revealed a pH of 7.12, pCO2of 132 mmHg, and arterial oxygen tension of 118 mm Hg. He was intubated and ventilated. Magnetic resonance imaging brain revealed herniation of the cerebellar tonsils along with brain stem and fourth ventricle. The patient underwent surgery and gradually weaned off. He was mobilized and discharged on day 6. Acute respiratory failure has not been reported with Chiari 1.5 malformation. The lesson to be learned from this case is that craniospinal pathology must be looked for in a patient with hypercapnic respiratory failure.


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