Generalised spinal cord atrophy, Chiari-I malformation, and syringomyelia

OBJECTIVES: To report the simultaneous occurrence of generalised spinal cord atrophy, Chiari-I malformation, and syringomyelia. SETTING: Vienna, Austria. CASE DESCRIPTION: An 83-year old woman presented with predominantly lower limb and distal tetraparesis, diffuse wasting, spasticity of both lower limbs, contractures, and severe kyphoscoliosis. Radiographic examinations revealed generalised spinal cord atrophy, Chiari-I malformation, and syringomyelia between C5 and C7. The generalised spinal cord atrophy was assumed to be due to either secondary atrophy or spontaneous collapse of a formerly more extensive syringomyelia. All other causes for generalised spinal cord atrophy were excluded. CONCLUSIONS: Generalised spinal cord atrophy in a patient with Chiari-I malformation and syringomyelia may be due to either secondary atrophy or spontaneous collapse of a formerly holocord syringomyelia. Myelography and MRI imaging of the spine are helpful in diagnosing this condition.