Hans Chiari

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

• Chiari H. Ueber Veränderungen des Kleinhirns infolge von Hydrocephalie des Grosshirns. Deutsche medizinische Wochenschrift 1891;17(42): 1172–1175 [Chiari malformations type 1 and type 2 aka Arnold–Chiari malformation]
• Chiari H. Erfahrungen über Infarktbildungen in der Leber des Menschen. Zeitschrift für Heilkunde, 1898; 19: 475-512.
• Chiari H. Ueber die selbständige Phlebitis obliterans der Hauptstämme der Venae hepaticae als Todesursache. Beiträge zur pathologischen Anatomie und zur allgemeinen Pathologie. 1899; 26: 1-18. [Beiträge zur Pathologie 1976; 158(1): 31-41] [Budd–Chiari syndrome]
• Chiari H. Die pathologische Anatomie im 19. Jahrhundert und ihr Einfluss auf die äussere Medizin. 1900
• Chiari H. Pathologisch-anatomische Sektionstechnik. 1907

References

• Pearce JM. Arnold chiari, or “Cruveilhier cleland Chiari” malformation. J Neurol Neurosurg Psychiatry. 2000; 68(1): 13.
• Loukas M, Noordeh N, Shoja MM, Pugh J, Oakes WJ, Tubbs RS. Hans Chiari (1851-1916). Childs Nerv Syst. 2008; 24(3): 407-9
• Tubbs RS, Cohen-Gadol AA. Hans Chiari (1851-1916). J Neurol. 2010; 257(7): 1218-20
• Bibliography. Chiari, Hans 1851-1916. WorldCat Identities
• Lange W. Ein Fall von Lebervenenobliteration. Inaugural Dissertation, University of Kiel. Schmidt & Klauning, Kiel. 1886;18.