A case of papilledema and Arnold-Chiari type i malformation
Pardo Muñoz, A.; Reche Sainz, J.A.; Sanz López, A.; Díaz Orro, B.; Lorenzo, G.; Sanmillán, J.
Archivos de la Sociedad Espanola de Oftalmologia 77(8): 449-453
2002
ISSN/ISBN: 0365-6691 PMID: 12185621 Document Number: 550771
A 12-year old girl was brought to the emergency ward because of headache and diplopia for 4 days. Bilateral papilledema was observed. Ancillary studies showed Arnold-Chiari Type I malformation without hydrocephalia. Cranial decompression treatment was performed but papilledema persisted and a progressive visual field deterioration was assessed. One month later, an optic nerve sheath fenestration was performed. Arnold-Chiari I malformation is characterized by downward displacement of cerebellar tonsils below the foramen magnum plane. It usually remains asymptomatic or appears in adulthood with brainstem compression-related symptoms. Surgical decompression of the posterior cranial fossa is mandatory in symptomatic cases. In our case, intracranial hypertension persisted because of postoperative subdural hygromas. Visual field deterioration was resolved by optic nerve sheath fenestration (Arch Soc Esp Oftalmol 2002; 77: 449-454).