Treated syringomyelia by occipital craniectomy
Numb hands, ? cervical radiculopathy
Before and after posterior fossa decompression
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Subtle tonsillar herniation through foramen magnum with cystic space in the mid-cervical cord (in the line of the central canal).
Following posterior fossa decompression with normal-appearing cerebellar tonsils and near resolution of the "syrinx" (and the patient's symptoms).
Resolution of syringomyelia following posterior fossa decompression alone indicates that the alteration to CSF flow dynamics caused by tonsillar herniation leads to syringomyelia (even focal central canal expansion) and that it can be corrected by re-establishment of normal CSF outflow from the IVth ventricle