Progression of Chiari I malformations while on growth hormone replacement: a report of two cases.

PURPOSE

The effect of growth hormone replacement on Chiari I malformation (CIM) associated with growth hormone deficiency is not clear.

CASE REPORTS

Two patients are presented, who were found to have CIM and growth hormone deficiency. While on hormone replacement therapy, both experienced disease progression with development of syringomyelia and required surgical intervention.

CONCLUSION

Growth hormone replacement for CIM associated with growth hormone deficiency does not uniformly halt or reverse syrinx progression. If a trial of hormone replacement is attempted, patients should be followed closely for progression of syringomyelia or the development of symptoms.