Spontaneous resolution of syringomyelia associated with an unruptured intracranial aneurysm: A case report

We report a rare association of an unruptured basilar artery aneurysm with cervicothoracic syringomyelia that spontaneously regressed without surgical intervention. A 56-year-old female presented with chronic unilateral neuropathic pain as well as a thoracic sensory level involving pain and temperature sensation. Initial spinal MRI revealed extensive syringomyelia associated with Chiari type I malformation. A basilar artery aneurysm was documented and showed enlargement over time. Follow-up MRIs demonstrated complete spontaneous regression of the syrinx. Axial imaging revealed a distinct parenchymal fissure within the spinal cord, which may provide a plausible structural explanation for cerebrospinal fluid drainage and subsequent syrinx resolution. This case underscores the role of spinal cord parenchymal fissuring in spontaneous syrinx regression and highlights the importance of detailed imaging for elucidating pathophysiological mechanisms in syringomyelia associated with vascular anomalies.