LESSONS The unusual course of this patient highlights the importance of guiding treatment by clinical symptoms, not radiological findings.ДЇurthermore it reflects the complexity of the pathophysiology and the uncertain natural history of syringomyelia. A review of the literature and the possible

Showed resolution, followed by reappearance and finally a complete resolution in 2021. Monitoring of the syrinx over a course of 8 years Conservative management was advocated as the patient was asymptomatic. OBSERVATIONS The authors describe an illustrative case of a 31-year-old female with an incidental finding of a CM1 malformation and cervical For many surgeons, the presence of a syrinx is an indication to offer surgery even if the patient is asymptomatic or mildly symptomatic. Symptomatic patients or asymptomatic patients with a syrinx, on the other hand, pose a more challenging dilemma, as the natural evolution is As a general consensus, symptomatic patients should be treated and asymptomatic patients without a syrinx should not be treated. Syringomyelia is frequently found in patients with CM1, but the pathophysiology of syringomyelia remains anД®nigma. It is reasonable to observe a patient with mild or asymptomatic symptoms, even in the presence of significant tonsillar descent or syringomyelia.Д«ACKGROUND Chiari Type I malformation (CM1) is a disorder recognized by caudal displacement of the cerebellar tonsils through the foramen

The natural history of mild symptomatic and asymptomatic CM-1 in adults is relatively benign and non-progressive, therefore the decision to perform surgical decompression should be based on the severity and duration of a patient's symptoms at presentation. Most asymptomatic individuals with CM-1 remained asymptomatic (93.3%), even in the presence of syringomyelia. 37-40% of patients with cough headache and 89% with nausea who were managed non-operatively improved at follow up. 27-47% had an improvement in their symptoms after 15 months. In symptomatic patients who did not undergo surgery, headaches and nausea often improved, whereas ataxia and sensory disturbance tended not to improve spontaneously. Inclusion and exclusion criteria were predefined. We conducted a systematic review of the literature to determine the natural history of CM-1 particularly in patients who did not undergo surgery, and in asymptomatic individuals, to help inform patients and doctors when surgery is likely to be beneficial.ДЄ systematic literature search was performed following PRISMA guidelines using the electronic databases PubMed, SCOPUS, the Cochrane foundation and Web of Science. Appreciation of this information is critical to determine how these patients should be managed. Conventional treatment is surgical decompression, but little is known about the natural history of patients who do not undergo surgical management. Chiari type 1 malformations (CM-1) are variations of hind-brain development which can sometimes occur in asymptomatic individuals.

Chiari malformation type 1