Arnold-Chiari malformation with syringomyelia in an elderly woman.
METHODS
A 76-year-old woman, complaining of leg pain and unsteady gait for 3 years, presented with a spastic paraparetic gait, severe spasticity and touch, thermal and pain sensory loss limited to arms, lower thorax and upper abdomen. Brain and spinal cord magnetic resonance imaging showed a large loculated syrinx. Cerebellar tonsillar herniation into the foramen magnum was also seen (Arnold-Chiari malformation, type I).


RESULTS
The patient had successful cervico-spinal surgical decompression which resulted in marked reduction in hypertonia and weakness, normal gait and normal joint movement at 6 months.


CONCLUSIONS
This unusual, late clinical presentation of a congenital disease underlines the importance of a comprehensive diagnostic work-up in the elderly patients with complex neurological signs.
Geroldi
C
C
Alzheimer's Unit, IRCCS S. Giovanni di Dio, Sacro Cuore Fatebenefratelli Hospital, Brescia, Italy.
Frisoni
G B
GB
Bianchetti
A
A
Trabucchi
M
M
Bricolo
A
A
D017668:Age of Onset; D000368:Aged; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D013595:Syringomyelia / Q000175:diagnosis / Q000209:etiology*