Protracted respiratory failure in a case of global spinal syringomyelia and Chiari malformation following administration of diazepam: illustrative case Article Swipe
Luke Bauerle
,
Brandon Rogowski
,
Aakash Shingala
,
Habib Emil Rafka
,
Timothy Webb
,
Brian F. Saway
,
Edward F. Kilb
,
Julio A. Chalela
,
Nathan C. Rowland
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3171/case23449
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3171/case23449
BACKGROUND Syringomyelia is defined as dilation of the spinal cord’s central canal and is often precipitated by skull base herniation disorders. Although respiratory failure (RF) can be associated with skull base abnormalities due to brainstem compression, most cases occur in pediatric patients and quickly resolve. The authors report the case of an adult patient with global spinal syringomyelia and Chiari malformation who developed refractory RF after routine administration of diazepam. OBSERVATIONS A 31-year-old female presented with malnutrition, a 1-month history of right-sided weakness, and normal respiratory dynamics. After administration of diazepam prior to magnetic resonance imaging (MRI), she suddenly developed hypercapnic RF followed MRI and required intubation. MRI disclosed a Chiari malformation type I and syrinx extending from C1 to the conus medullaris. After decompressive surgery, her respiratory function progressively returned to baseline status, although 22 months after initial benzodiazepine administration, the patient continues to require nocturnal ventilation. LESSONS Administration of central nervous system depressants should be closely monitored in patients with extensive syrinx formation given the potential to exacerbate diminished central respiratory drive. Early identification of syrinx in the context of Chiari malformation and hemiplegia should prompt clinical suspicion of underlying respiratory compromise and early involvement of intensive care consultants.
Related Topics
Concepts
Medicine
Syringomyelia
Surgery
Context (archaeology)
Respiratory failure
Anesthesia
Syrinx (medicine)
Chiari malformation
Magnetic resonance imaging
Radiology
Biology
Paleontology
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3171/case23449
- https://thejns.org/downloadpdf/view/journals/j-neurosurg-case-lessons/6/21/article-CASE23449.pdf
- OA Status
- hybrid
- References
- 40
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4388841380
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4388841380Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3171/case23449Digital Object Identifier
- Title
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Protracted respiratory failure in a case of global spinal syringomyelia and Chiari malformation following administration of diazepam: illustrative caseWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-11-20Full publication date if available
- Authors
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Luke Bauerle, Brandon Rogowski, Aakash Shingala, Habib Emil Rafka, Timothy Webb, Brian F. Saway, Edward F. Kilb, Julio A. Chalela, Nathan C. RowlandList of authors in order
- Landing page
-
https://doi.org/10.3171/case23449Publisher landing page
- PDF URL
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https://thejns.org/downloadpdf/view/journals/j-neurosurg-case-lessons/6/21/article-CASE23449.pdfDirect link to full text PDF
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YesWhether a free full text is available
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hybridOpen access status per OpenAlex
- OA URL
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https://thejns.org/downloadpdf/view/journals/j-neurosurg-case-lessons/6/21/article-CASE23449.pdfDirect OA link when available
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Medicine, Syringomyelia, Surgery, Context (archaeology), Respiratory failure, Anesthesia, Syrinx (medicine), Chiari malformation, Magnetic resonance imaging, Radiology, Biology, PaleontologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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40Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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