A 2-day-old male presents with stridor, poor feeding, and recurrent apneic episodes requiring intermittent bag-mask ventilation. Vital signs show HR 155 bpm, RR 42/min, BP 65/38 mmHg, and SpO2 88% on room air. Examination reveals bilateral lower-extremity weakness and absent anal wink. Spinal MRI demonstrates a lumbosacral myelomeningocele with normal cerebrospinal fluid protein levels. Cranial nerve examination is intact. Which posterior fossa abnormality is most likely also present?
- A)Downward displacement of cerebellar tonsils only
- B)Smooth cerebral surface due to failed neuronal migration
- C)Downward displacement of cerebellum and medulla through the foramen magnumGABARITO
- D)Failure of the forebrain to divide into two hemispheres
- E)Agenesis of the cerebellar vermis with enlarged posterior fossa
Explicação
Downward displacement of cerebellum and medulla through the foramen magnum is the correct answer because Chiari II malformation is strongly associated with myelomeningocele and presents early with brainstem dysfunction, dysphagia, stridor, and apnea. Ver explicação completa e trilha adaptativa →