Gallo Elizabeth, Rahmathulla Gazanfar, Rao Dinesh, Tavanaiepour Kourosh, Tavanaiepour Daryoush
Department of Neurosurgery, and.
Division of Neuroradiology, University of Florida, College of Medicine, Jacksonville, Florida.
J Neurosurg Case Lessons. 2021 Jun 28;1(26):CASE21236. doi: 10.3171/CASE21236.
Chiari malformations include a spectrum of congenital hindbrain herniation syndromes. In patients with the most common subtype, Chiari malformation Type I, 50% to 75% develop a syrinx. The pathogenesis of syringomyelia is not well understood, with multiple theories outlined in the literature. Although the presence of a syrinx in a patient with Chiari malformation is generally accepted as an indication for surgical intervention, there are documented cases of spontaneous resolution that support a more conservative approach to management.
The authors reported a case of spontaneous resolution of a cervical syrinx in an adult with an unchanged Chiari malformation.
Given the possibility of spontaneous resolution over time, the authors believe a more conservative approach of observation with periodic surveillance, magnetic resonance imaging, and neurological examination should be considered in the management of a patient with a Chiari malformation and associated syringomyelia.
Chiari畸形包括一系列先天性后脑疝综合征。在最常见的亚型Chiari I型患者中，50%至75%会出现脊髓空洞症。脊髓空洞症的发病机制尚不完全清楚，文献中概述了多种理论。虽然Chiari畸形患者出现脊髓空洞症通常被认为是手术干预的指征，但有记录显示存在自发缓解的病例，这支持了一种更保守的治疗方法。
作者报告了一例成年患者颈段脊髓空洞症自发缓解且Chiari畸形无变化的病例。
鉴于随着时间推移有自发缓解的可能性，作者认为在Chiari畸形及相关脊髓空洞症患者的治疗中，应考虑采用更保守的观察方法，定期进行监测、磁共振成像和神经学检查。
