{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:17:54Z","timestamp":1770887874847,"version":"3.50.1"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T00:00:00Z","timestamp":1675468800000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg Rep"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Intraoperative neuromonitoring (IONM) has been used in neurosurgical procedures to assess patient safety and minimize risk of neurological deficit. However, its use in decompressive surgeries of Chiari malformation type I (CM-I) remains a topic of debate. Here we present the case of a 5-year-old girl who presented with acute right lower extremity monoplegia after accidental self-induced hyperflexion of the neck while playing. Imaging revealed 15\u2009mm of tonsillar ectopia with cervical and upper thoracic spinal cord edema. She was taken to surgery for a suboccipital decompression with expansile duraplasty. IONM demonstrated improvement in motor evoked potentials during the decompression. Postoperatively, she had full recovery of strength and mobility. This is a case of acute weakness after mild trauma in the setting of previously asymptomatic CM-I that showed close correlation with IONM, clinical findings, and imaging. IONM during decompressive surgery for CM-I may be useful in patients who present acutely with cervical cord edema.<\/jats:p>","DOI":"10.1055\/a-2028-6419","type":"journal-article","created":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T23:29:15Z","timestamp":1675553355000},"page":"e26-e30","source":"Crossref","is-referenced-by-count":1,"title":["Use of Intraoperative Neuromonitoring in Surgical Treatment of Acute Presentation of Chiari I Malformation: A Case Report"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-5514","authenticated-orcid":false,"given":"Christina","family":"Ng","sequence":"additional","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sima","family":"Vazquez","sequence":"additional","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose","family":"Auerbach-Tash","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandria F.","family":"Naftchi","sequence":"additional","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-3014","authenticated-orcid":false,"given":"Jose F.","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7186-1882","authenticated-orcid":false,"given":"Aalok R.","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Maria Fareri Children's Hospital, New York Medical College, Valhalla, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Overby","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Westchester Medical Center, Maria Fareri Children's Hospital, Valhalla, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie R.","family":"Muh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Westchester Medical Center, Maria Fareri Children's Hospital, New York Medical College, Valhalla, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1007\/s00701-021-04842-y","article-title":"Preoperative measurements on MRI in Chiari 1 patients fail to predict outcome after decompressive surgery","volume":"163","author":"M P Jussila","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.wneu.2017.04.082","article-title":"Chiari malformation type 1: a systematic review of natural history and conservative management","volume":"104","author":"B Langridge","year":"2017","journal-title":"World Neurosurg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s00381-019-04398-4","article-title":"Systematic review and meta-analysis of imaging characteristics in Chiari I malformation: does anything 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