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Symptomatic Chiari type 1 malformation associated with acromegaly: A case report
Takuma Aoki1, Daisuke Umebayashi2, Kazunori Tatsuzawa2
1Department of Neurosurgery, Saiseikai Shiga Hospital, Ritto, Japan.
Surgical Neurology International
|July 5, 2021
Summary
Symptomatic Chiari I malformation (CM1) with syrinx and acromegaly can coexist. Treatment involves surgical decompression and management of the growth hormone-producing pituitary adenoma.
Area of Science:
- Neurology
- Endocrinology
- Neurosurgery
Background:
- Chiari I malformation (CM1) is a condition where brain tissue extends into the spinal canal.
- Syringomyelia is a disorder characterized by the development of a fluid-filled cyst (syrinx) within the spinal cord.
- Acromegaly is a hormonal disorder caused by excessive growth hormone production.
Observation:
- A 63-year-old female presented with symptoms of both CM1 and acromegaly.
- Cervical MRI revealed CM1 with a syrinx extending from C2 to T5.
- The patient also had chronic, untreated signs of acromegaly.
Findings:
- Surgical decompression (foramen magnum decompression and C1 posterior arch resection) resolved CM1 and syrinx symptoms.
- A growth hormone-producing pituitary lesion was identified and treated with endocrine therapy.
- The patient's acromegaly was managed concurrently with treatment for colon cancer.
Implications:
- This case highlights the potential co-occurrence of symptomatic CM1, syrinx, and acromegaly.
- Integrated treatment approaches are crucial for managing these complex conditions.
- Effective management may involve neurosurgical intervention followed by endocrine or surgical treatment for pituitary adenomas.
