Tsao T C, Juang Y C, Chiang Y C, Tsai Y H, Lan R S, Lee C H
Department of Chest Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Chest. 1991 May;99(5):1294-5. doi: 10.1378/chest.99.5.1294.
A 47-year-old woman was admitted for bilateral lower lobe pneumonia with respiratory distress. Two episodes of respiratory failure developed despite improvement of pneumonia after antibiotic chemotherapy. Loss of consciousness and quadriplegia accompanied the last episode of respiratory failure. Arnold-Chiari malformation type 1 was diagnosed and a suboccipital craniectomy was performed. The neuromuscular and respiratory disorders greatly improved after operation. We believe that ACM 1 should be considered when an adult develops unexpected respiratory failure after improvement of the primary pulmonary condition. This disease is potentially treatable by surgical management, and if it is misdiagnosed, will be fatal.
一名47岁女性因双侧下叶肺炎伴呼吸窘迫入院。尽管抗生素化疗后肺炎有所改善，但仍发生了两次呼吸衰竭。最后一次呼吸衰竭发作时伴有意识丧失和四肢瘫痪。诊断为1型阿诺德-奇阿利畸形，并进行了枕下颅骨切除术。术后神经肌肉和呼吸障碍有显著改善。我们认为，当成年人在原发性肺部疾病改善后出现意外的呼吸衰竭时，应考虑1型阿诺德-奇阿利畸形。这种疾病通过手术治疗有潜在的治愈可能，若误诊则会致命。
