Lou Chengjian, Wang Linkai, Pan Xiaoli, Xu Dan, Chen Yili
Department of Neurosurgery, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, China.
Brain Spine. 2025 Jul 3;5:104312. doi: 10.1016/j.bas.2025.104312. eCollection 2025.
Chiari malformation type I (CM1) with syringomyelia caused by supratentorial lesions is extremely rare, and the mechanism has not been well explained.
A 25-year-old female patient with no significant medical history who presented with progressive pain in the left neck for one month. MRI examination showed a giant meningioma in the trigone of the lateral ventricle accompanied with CM1 and syringomyelia.
The patient underwent left parietal-occipital cortical approach surgery to remove the giant tumor in the trigone of the left lateral ventricle. The neck pain and left upper limb numbness were relieved immediately. CM1 and syringomyelia disappeared without posterior fossa decompression after surgical resection of the supratentorial tumor.
This case shows that supratentorial space-occupying lesions (SOLs) causing acquired Chiari malformation (ACM) and syringomyelia is closely related to the tumor oppresses and increases the pressure of the posterior cranial fossa. Posterior fossa decompression was not needed for ACM and syringomyelia.
幕上病变导致的Ⅰ型Chiari畸形（CM1）合并脊髓空洞症极为罕见，其机制尚未得到很好的解释。
一名25岁女性患者，无重大病史，出现左侧颈部进行性疼痛1个月。MRI检查显示侧脑室三角区巨大脑膜瘤，伴有CM1和脊髓空洞症。
患者接受左侧顶枕皮质入路手术，切除左侧侧脑室三角区的巨大肿瘤。术后颈部疼痛和左上肢麻木立即缓解。幕上肿瘤切除后，未行后颅窝减压，CM1和脊髓空洞症消失。
该病例表明，幕上占位性病变（SOLs）导致的获得性Chiari畸形（ACM）和脊髓空洞症与肿瘤压迫及后颅窝压力升高密切相关。ACM和脊髓空洞症无需行后颅窝减压。
