You are here

Article Text

Article menu
Download PDFPDF
Case report
Spontaneous resolution of a Chiari malformation with syringomyelia
  1. Hadleigh Cuthbert,
  2. Joshua Pepper and
  3. Rupert Price
  1. Department of Neurosurgery, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK
  1. Correspondence to Hadleigh Cuthbert; hadleigh.cuthbert{at}nhs.net

Abstract

The Chiari I malformation (CM-I) is characterised by overcrowding of the posterior fossa and descent of the cerebellar tonsils and is associated with syringomyelia. With the increasing availability of magnetic resonance imaging, CM-I is placing a growing burden on neurosurgical services. However, its natural history remains poorly understood, and the timing and nature of surgical intervention is controversial. We present a case of a significant, symptomatic CM-I with associated syrinx which underwent complete spontaneous resolution over a 4-year period. Spontaneous regression of Chiari malformation and syringomyelia is exceedingly rare; a literature review reveals 15 other cases and only one case which underwent complete resolution. The present case and literature review suggest a more benign natural history of CM-I and support a more conservative approach to its management. Further studies are required to determine whether any factors can predict resolution for certain patient cohorts.

  • spinal cord
  • neurosurgery

https://doi.org/10.1136/bcr-2021-241789

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors All authors certify that they have participated sufficiently in the work to take public responsibility for the content. HC and JP contributed to the acquisition of patient data, data collection for the literature review, analysis and interpretation of the literature review and drafting of the manuscript. RP contributed to the conception of the case report and revised the manuscript critically for important intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.