Skip to main content

Advertisement

Log in

Spontaneous resolution of syringomyelia in an adult patient with tight cisterna magna

  • Case Report
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Spontaneous resolution of syringomyelia in adult patients with Chiari malformation is exceptionally rare, with only 10 cases having been reported. A 21-year-old man working as a carpenter presented with a 1-year history of paresthesias in his right arm. A magnetic resonance imaging scan disclosed a cervicothoracic syrinx associated with tight tonsillar impaction of the cisterna magna without herniation. The patient left the carpentry job and underwent close monitoring with serial clinical and neuroradiological controls. The patient’s symptoms gradually disappeared and magnetic resonance imaging studies revealed progressive shrinkage of the syrinx despite persistence of crowding of posterior fossa structures at the level of the foramen magnum. This case suggests that spontaneous resolution of syringomyelia can occasionally be triggered by the cessation of daily physical strain in patients with tight cisterna magna. Health care professionals should be aware that strenuous physical activities could affect the natural history of syringomyelia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Olfield EH, Muraszko K, Shawker TH, Patronas NJ (1994) Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils. Implications for diagnosis and treatment. J Neurosurg 80:3–15

    Article  Google Scholar 

  2. Aboulez AO, Sartor K, Geyer CA, Gado MH (1985) Position of cerebellar tonsils in the normal population and in patients with Chiari malformation: a quantitative approach with MR imaging. J Comput Assist Tomogr 9:1033–1036

    Article  Google Scholar 

  3. Iskandar BJ, Hedlund GL, Grabb PA, Oakes WJ (1998) The resolution of syringohydromyelia without hindbrain herniation after posterior fossa decompression. J Neurosurg 89:212–216

    Article  PubMed  CAS  Google Scholar 

  4. Kyoshima K, Kuroyanagi T, Oga F, Kamijo Y, El-Noamany H, Kobayashi S (2002) Syringomyelia without hindbrain herniation: tight cisetrna magna. Report of four cases and review of the literature. J Neurosurg 96:239–249

    PubMed  Google Scholar 

  5. Boman K, Livanainen M (1967) Prognosis of syringomyelia. Acta Neurol Scand 43:61–68

    Article  PubMed  CAS  Google Scholar 

  6. Williams B (1978) A critical appraisal of posterior fossa surgery for communicating syringomyelia. Brain 101:223–250

    Article  PubMed  CAS  Google Scholar 

  7. Nishizawa S, Yokoyama T, Yokota N, Tokuyama T, Ohta S (2001) Incidentally identified syringomyelia associated with Chiari I malformations: is early interventional surgery necessary? Neurosurgery 49:637–641

    PubMed  CAS  Google Scholar 

  8. Coppa ND, Kim HJ, McGrail KM (2006) Spontaneous resolution of syringomyelia and Chiari malformation type I in a patient with cerebrospinal fluid otorrhea. J Neurosurg 105:769–771

    Article  PubMed  Google Scholar 

  9. Deniz FE, Oksüz E (2009) Spontaneous syringomyelia resolution at an adult Chiari type I malformation. Turk Neurosurg 19:96–98

    PubMed  Google Scholar 

  10. Fukutake T, Hattori T (1998) Reversible hydromyelia in a synchronised swimmer with recurrent girdle pains. J Neurol Neurosurg Psychiatry 65:606

    Article  PubMed  CAS  Google Scholar 

  11. Jack CR, Kokmen E, Onofrio BM (1991) Spontaneous decompression of syringomyelia: magnetic resonance imaging findings. Case report. J Neurosurg 74:283–286

    Article  PubMed  Google Scholar 

  12. Klekamp J, Iaconetta G, Samii M (2001) Spontaneous resolution of Chiari I malformation and syringomyelia: case report and review of the literature. Neurosurgery 48:664–667

    Article  PubMed  CAS  Google Scholar 

  13. Kyoshima K, Bogdanov EI (2003) Spontaneous resolution of syringomyelia: report of two cases and review of the literature. Neurosurgery 3:762–769

    Article  Google Scholar 

  14. Santoro A, Delfini R, Innocenzi G, Di Biasi C, Transimeni G, Gualdi G (1993) Spontaneous drainage of syringomyelia. Report of two cases. J Neurosurg 79:132–134

    Article  PubMed  CAS  Google Scholar 

  15. Sudo K, Tashiro K, Miyasaka K (1998) Features of spontaneous improvement in syringomyelia with low-situated cerebellar tonsils. Acta Neurol Belg 98:342–346

    PubMed  CAS  Google Scholar 

  16. Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson B (2000) Asymptomatic Chiari type I malformations identified on magnetic resonance imaging. J Neurosurg 92:920–926

    Article  PubMed  CAS  Google Scholar 

  17. Oakes WJ (1996) Chiari malformations, hydromyelia, syringomyelia. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 3593–3616

    Google Scholar 

  18. Novegno F, Caldarelli M, Massa A et al (2008) The natural history of the Chiari I anomaly. J Neurosurg Pediatrics 2:179–187

    Article  Google Scholar 

  19. Mikulis DJ, Diaz O, Egglin TK, Sanchez R (1992) Variance of the position of the cerebellar tonsils with age: preliminary report. Radiology 183:725–728

    PubMed  CAS  Google Scholar 

  20. Milhorat TH, Capocelli AL Jr, Anzil AP, Kotzen RM, Milhorat RH (1995) Pathological basis of spinal cord cavitation in syringomyelia: analysis of 105 autopsy cases. J Neurosurg 82:802–812

    Article  PubMed  CAS  Google Scholar 

  21. Girard N, Lasjaunias P, Taylor W (1994) Reversible tonsilla prolapse in vein of Galen aneurysmal malformations: report of eight cases and pathophysiological hypothesis. Childs Nerv Syst 10:141–147

    Article  PubMed  CAS  Google Scholar 

  22. Rodesch G, Otto B, Mouchamps M, Born J (2007) Reversible tonsillar prolapse and syringomyelia after embolization of a tectal arteriovenous malformation. Case report and review of the literature. J Neurosurg 107:412–415

    Article  PubMed  Google Scholar 

  23. Sun JC, Steinbok P, Cochrane DD (2000) Spontaneous resolution and recurrence of a Chiari I malformation and associated syringomyelia. Case report. J Neurosurg 92:207–210

    PubMed  CAS  Google Scholar 

  24. Tubbs RS, Elton S, Grabb P, Dockery SE, Bartolucci AA, Oakes WJ (2001) Analysis of the posterior fossa in children with Chiari 0 malformation. Neurosurgery 48:1050–1055

    Article  PubMed  CAS  Google Scholar 

  25. Heiss JD, Patronas N, DeVroom HL et al (1999) Elucidating the pathophysiology of syringomyelia. J Neurosurg 91:553–562

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paolo Perrini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Perrini, P. Spontaneous resolution of syringomyelia in an adult patient with tight cisterna magna. Neurol Sci 33, 1463–1467 (2012). https://doi.org/10.1007/s10072-012-0946-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-012-0946-8

Keywords

Navigation