title: Spinal cord edema preceding syringomyelia associated with Chiari I malformation--case report.
abstract: A 38-year-old woman with Chiari I malformation presented with spinal cord edema preceding syringomyelia manifesting as a 5-month history of nuchal pain and numbness of the upper extremities. Magnetic resonance imaging showed spinal cord edema, a poorly defined syrinx at the C-2 to T-2 levels, and distorted cerebellar tonsils. Computed tomography revealed cerebrospinal fluid (CSF) density in the center of spinal cord edema, and positron emission tomography revealed no uptake of L-[methyl-11C]methionine, indicating a non-neoplastic lesion. Craniocervical decompression achieved excellent clinical and neuroradiological outcomes. The success of surgical treatment supports the theory that patients with Chiari I malformation have increased transmural flow of CSF, causing spinal cord edema that progresses to syringomyelia. Early treatment of patients with spinal cord edema is indicated to prevent permanent spinal cord injury due to progressive syringomyelia.
authors.affiliation: Department of Neurosurgery, Akita University School of Medicine, Japan. yasuitoh@nsg.med.akita-u.ac.jp
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Itoh
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kuwahara
authors.forename: Toshio
authors.initials: T
authors.lastname: Sasajima
authors.forename: Kazuo
authors.initials: K
authors.lastname: Mizoi
authors.forename: Jun
authors.initials: J
authors.lastname: Hatazawa
mesh_terms: D000328:Adult; D001139:Arnold-Chiari Malformation / Q000175:diagnosis* / Q000601:surgery; D003399:Craniotomy; D003952:Diagnostic Imaging; D004487:Edema / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007796:Laminectomy; D013116:Spinal Cord / Q000473:pathology; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000601:surgery; D013595:Syringomyelia / Q000175:diagnosis* / Q000601:surgery