Enhancing nodular lesions in Chiari II malformations in the setting of persistent hindbrain herniation: case report and literature review

Alexa Semonche, Ashish H. Shah, Daniel G. Eichberg, Sakir H. Gultekin, Ricardo J. Komotar, Michael E. Ivan

Research output: Contribution to journalArticle

Abstract

Background: Chiari II malformation includes concomitant cerebellar tonsillar herniation, hydrocephalus, and myelomeningocele. Rarely, pediatric patients with persistent hindbrain herniation develop a new enhancing nodule at the cervicomedullary junction as adults. These new lesions may be suspicious for neoplastic growth, but it remains unclear if neurosurgical intervention is necessary. Case Report: A 27-year-old female patient with history of Chiari II malformation and persistent hindbrain herniation presented with a 3-month history of headache and upper extremity weakness and numbness. Neuroimaging revealed a new enhancing nodule near the cervicomedullary junction suspicious for neoplasm. Following posterior fossa decompression and excision of the enhancing lesion, pathological analysis demonstrated only benign glioneural heterotopia. Results: New enhancing nodules at the cervicomedullary junction in Chiari II malformation are exceedingly rare and are likely benign, reactive changes rather than a neoplastic process. Biopsy or surgical excision of these lesions is likely unnecessary for asymptomatic patients.

Original languageEnglish (US)
JournalChild's Nervous System
DOIs
StatePublished - Jan 1 2019

Keywords

  • Chiari II malformation
  • Neurodevelopmental disorders
  • Pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Enhancing nodular lesions in Chiari II malformations in the setting of persistent hindbrain herniation: case report and literature review'. Together they form a unique fingerprint.

  • Cite this