CO2-induced intracranial hypertension and high-amplitude B-waves in a patient with Chiari 1 malformation and sleep apnea syndrome that resolved following CPAP therapy

Acta Neurochir (Wien). 2021 Nov;163(11):3075-3082. doi: 10.1007/s00701-021-04717-2. Epub 2021 Feb 2.

Abstract

Headaches and cognitive impairment in the elderly population have been described as symptoms related to obstructive sleep apnea (OSA). Although papilledema has been observed in some of these patients, suggesting intracranial hypertension (ICH), there are only a few studies in which intracranial pressure (ICP) has been continuously measured in patients with OSA without neurological disease. We present a patient diagnosed with Chiari Type 1 malformation and OSA, who present normal ICP recording during the day and nocturnal ICH associated with high amplitude B-waves and hypercapnia during obstructive apneas, which disappeared following continuous positive airway pressure (CPAP) therapy. The normalization of the cerebral and respiratory parameters with CPAP therapy is important for performing the correct treatment in these patients.

Keywords: Chiari malformation type 1; Continuous positive airway pressure; Hypercapnia; ICP B-waves; Intracranial hypertension; Obstructive sleep apnea.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carbon Dioxide
  • Continuous Positive Airway Pressure
  • Humans
  • Intracranial Hypertension*
  • Sleep Apnea Syndromes*
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / therapy

Substances

  • Carbon Dioxide