Laparoscopic cholecystectomy in a morbidly obese patient with Chiari I malformation and craniocervical anomalies.

Chiari I malformation is the downward herniation of cerebellar tonsils through the foramen magnum, and is frequently associated with craniocervical anomalies. Laparoscopic surgery can cause an increase in intracranial pressure due to the obstruction of the foramen magnum. The successful administration of general anesthesia in a 50-year-old, morbidly obese woman with a difficult airway, scheduled for laparoscopic cholecystectomy, who was incidentally diagnosed with Chiari I malformation associated with craniocervical anomalies, is presented.