Respiratory distress and Arnold-Chiari malformation.

Fourteen children with Arnold-Chiari malformation had history of respiratory distress, apnea, vocal cord paralysis or inability to swallow. Postmortem examination in 12 disclosed vascular lesions in the tegmentum of the medulla oblongata. The length of survival of these children was markedly shorter than of those without such history and anatomic findings. It is suggested that the malformation results in changes in the vascular supply of the herniated portion of the brainstem. Stretching of the arteries may result in irreversible damage to the brainstem with subsequent life-threatening disturbance of respiratory function.