Spontaneous regression of post-traumatic syringomyelia: longitudinal mr imaging demonstrating a dynamic disease course.
Carlos Dier, Charif Sidani, Kevin J Abrams et al.
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Case in brief
A 69-year-old patient with post-traumatic cervicothoracic syringomyelia presented with occipital headaches, dizziness, and subjective upper-extremity weakness. Initial MRI showed a focal expansile syrinx at C7–T1, without enhancement, cerebrospinal fluid flow obstruction, or Chiari malformation. Serial imaging showed mild enlargement followed by progressive reduction and near-complete spontaneous resolution over 13 years, leaving a slit-like cavity and focal cord thinning. Neurologic examinations remained normal, and the symptoms resolved without surgery.
What made this case unusual
The syrinx first enlarged mildly, then regressed to near-complete radiologic resolution without surgical intervention, while the patient remained neurologically stable.
Diagnostic / clinical pearl
Post-traumatic syringomyelia may have a dynamic course; correlate serial MRI findings with clinical status rather than assuming progressive enlargement.
Why it matters
The case supports close clinical and imaging follow-up in selected patients, as spontaneous radiologic resolution can occur without surgery.