Radiographic formation and progression of cervical syringomyelia in a child with untreated Chiari I malformation.

We present the case of a 17-month-old girl with an untreated Chiari I malformation who developed radiographic progression of syringomyelia over a 23-month period. The patient presented with initial symptoms of airway difficulties and gait ataxia, which did not progress clinically over this period of observation, despite recommendations for surgical decompression. At 17 months, there was a region of T(2) hyperintensity which progressed to become a syrinx within 3 months, enlarging over serial imaging studies. This is the first published report of radiographic progression from a 'presyrinx' state of T(2) hyperintensity to syringomyelia in a pediatric patient with untreated Chiari I malformation. Copyright (c) 2008 S. Karger AG, Basel.