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Hans Chiari

Hans Chiari (1851 – 1916)

Hans Chiari (1851-1916) was an Austrian pathologist.

Chiari published across a wide range of pathology, including malformations of the brainstem and cerebellum, hepatic vein thrombosis, aortooesophageal fistula, choriocarcinoma, carotid artery plaques and thrombosis, autodigestion of the pancreas, and connections between the eustachian and thebesian heart valves.,

He is eponymously affiliated with the Chiari malformations; Type II Chiari malformation (Arnold–Chiari malformation) and Budd–Chiari syndrome (1899).


Biography

  • Born 4 November 1851 in Vienna, Austria
  • Studied medicine in Vienna and worked as an assistant at the Vienna Institute of Pathology under Karl Rokitansky (1804–1878)
  • 1875 – Graduated medical school from the Unviersity of Vienna
  • 1878 – Habilitated in pathological anatomy in Vienna
  • 1882 – Professor extraordinarius of pathology at the German University in Prague
  • 1883 – Appointed professor ordinarius and superintendent of the pathological-anatomical museum in Prague
  • 1906 – Commenced as professor ordinarius at the University of Strasbourg
  • Died 6 May 1916 in Strasbourg following a throat infection

Medical Eponyms

Budd–Chiari syndrome (1899)

Obstruction of hepatic venous outflow

Hans Chiari published a case series of three patients with hepatic vein thrombosis, and a literature review of seven additional patients. He named the disease ‘phlebitis obliterans‘, and postulated that the thrombosis was a complication of endo-phlebitis likely from syphilis. Lange postulated an inflammatory process in hepatic vein thrombosis prior, in 1886. Pathology of showed congested and necrotic livers, porto-mesenteric circulation congestion, large volume ascites, and minimal adventitial reaction without perivascular involvement on histology. Chiari provided the first clinical and pathological correlations of this syndrome.


Arnold–Chiari malformation (1891, 1894, 1896)

Descent of the cerebellar tonsils and vermis, medulla and pons, with associated elongation and displacement of the fourth ventricle. Frequently occurs with hydrocephalus and also associate with myelomeningocele. Chiari credited others in his writing regarding the type 2 malformation – namely John Cleland and Julius Arnold, the former of whom had briefly described similar pot-mortem findings in a child in 1883.

Chiari malformations – abnormalities of the brain stem and cerebellum identified by Chiari on post-mortems. Type 1 (1891) – peg-like elongation of the cerebellar tonsils into the spinal canal through the foramen magnum; Type 2 aka Arnold Chiari malformation and Type 3 and 4.

Chiari network – mobile net-like connections between the valve of the coronary sinus and the valve of the inferior vena cava. An anatomical variant, usually of no clinical significance.


Major Publications


References


Doctor in Australia. Keen interest in internal medicine, medical education, and medical history.

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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