Reversible hydromyelia in Chiari malformation

Case contributed by Varun Babu
Diagnosis almost certain

Presentation

Initial presentation - dorsal back ache, non radiating.

Patient Data

Age: 35 years
Gender: Female

Brain (at presentation)

mri
  • normal development of supratentorial neuroparenchyma.
  • well developed posterior fossa.
  • both cerebellar hemispheres as well as vermis are well formed. 
  • tonsillar herniation and cervicomedullary impingement. 
  • unremarkable upper cervical cord. 

2 years later

mri
  • patient presented again with symptoms of quadriparesis. 
  • cervical cord C5 to C7 level segmental central canal widening suggestive of rising cervical cord CSF pressure due to cervicomedullary compression. 

1st month post surgery

mri
  • appreciable relief in the hydromyelia with post operative changes seen in the occipital bone. 

9 months post surgery

mri
  • complete resolution of cervical cord hydromyelia. 

Case Discussion

The beauty of the ability of the human body to naturally find alternative ways to combat stress is depicted here wherein there is distension of a central canal that becomes redundant after development. The relief in the pressure at the cervicomedullary junction coupled with free CSF flow enabled the restoration of normal function of the CSF system and thereby disappearance of the hydromyelia.   

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.