Abstract
Objective
Familial cases of Chiari malformation with syringomyelia are rare. The majority of the reported series and case reports detail sporadic cases. The authors report two siblings who presented with Chiari type I malformation and syringomyelia (CMI+S).
Clinical presentation
We report two sisters who each presented with scoliosis on routine school physicals. Their clinical examination was unremarkable; however, imaging studies demonstrated a Chiari malformation with syringomyelia. Both underwent cervicomedullary decompression, and follow-up imaging studies revealed resolution of the syringomyelia.
Conclusion
A review of the literature reveals fewer than ten previous reports of familial CMI+S in the past 30 years. Although rare, the existence of familial cases of CMI+S suggests a genetic component to the pathogenesis of this condition in at least a proportion of patients. Neurosurgeons should be aware of the familial aggregation of CMI+S.
References
Alzate J, Kothbauer K, Jallo G, Epstein F (2001) Treatment of Chiari type I malformation in patients with and without syringomyelia: a consecutive series of 66 cases. Neurosurg Focus 11:Article 3
Atkinson JL, Kokmen E, Miller GM (1998) Evidence of posterior fossa hypoplasia in the familial variant of adult Chiari I malformation: case report. Neurosurgery 42:401–403 (discussion 404)
Attal N, Parker F, Tadie M, Aghakani N, Bouhassira D (2004) Effects of surgery on the sensory deficits of syringomyelia and predictors of outcome: a long term prospective study. J Neurol Neurosurg Psychiatry 75:1025–1030
Azimullah PC, Smit LM, Rietveld-Knol E, Valk J (1991) Malformations of the spinal cord in 53 patients with spina bifida studied by magnetic resonance imaging. Childs Nerv Syst 7:63–66
Bentley SJ, Campbell MJ, Kaufmann P (1975) Familial syringomyelia. J Neurol Neurosurg Psychiatry 38:346–349
Caraceni T, Giovannini P (1977) Familial syringomyelia: a report of four cases. Arch Psychiatr Nervenkr 224:331–340
Cavender RK, Schmidt JH III (1995) Tonsillar ectopia and Chiari malformations: monozygotic triplets. Case report. J Neurosurg 82:497–500
Colombo A, Cislaghi MG (1993) Familial syringomyelia: case report and review of the literature. Ital J Neurol Sci 14:637–639
Gimenez-Roldan S, Benito C, Mateo D (1978) Familial communicating syringomyelia. J Neurol Sci 36:135–146
Iglesias-Osma C, Gomez Sanchez JC, Suquia Mugica B, Querol Prieto R, de Portugal Alvarez J (1997) Paget’s disease of bone and basilar impression associated with an Arnold–Chiari type-1 malformation. An Med Interna 14:519–522
Inoue M, Nakata Y, Minami S, Kitahara H, Otsuka Y, Isobe K, Takaso M, Tokunaga M, Itabashi T, Nishikawa S, Moriya H (2003) Idiopathic scoliosis as a presenting sign of familial neurologic abnormalities. Spine 28:40–45
Iskandar BJ, Oakes WJ, McLaughlin C, Osumi AK, Tien RD (1994) Terminal syringohydromyelia and occult spinal dysraphism. J Neurosurg 81:513–519
Malessa R, Jorg J (1986) Discordant syringomyelia twins in familial syringomyelia. Nervenarzt 57:422–426
McDonnell GV, McCann JP, Craig JJ, Crone M (2000) Prevalence of the Chiari/hydrosyringomyelia complex in adults with spina bifida: preliminary results. Eur J Pediatr Surg 10(Suppl 1):18–19
Meadows J, Kraut M, Guarnieri M, Haroun RI, Carson BS (2000) Asymptomatic Chiari type I malformations identified on magnetic resonance imaging. J Neurosurg 92:920–926
Mesiwala AH, Shaffrey CI, Gruss JS, Ellenbogen RG (2001) Atypical hemifacial microsomia associated with Chiari I malformation and syrinx: further evidence indicating that Chiari I malformation is a disorder of the paraaxial mesoderm. Case report and review of the literature. J Neurosurg 95:1034–1039
Milhorat TH, Capocelli AL Jr, Anzil AP, Kotzen RM, Milhorat RH (1995) Pathological basis of spinal cord cavitation in syringomyelia: analysis of 105 autopsy cases. J Neurosurg 82:802–812
Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, Speer MC (1999) Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 44:1005–1017
Morrison PJ, Mulholland HC, Craig BG, Nevin NC (1992) Cardiovascular abnormalities in the oculo-auriculo-vertebral spectrum (Goldenhar syndrome). Am J Med Genet 44:425–428
Nakai T, Asato R, Miki Y, Tanaka F, Matsumoto S, Konishi J (1995) A case of achondroplasia with downward displacement of the brain stem. Neuroradiology 37:293–294
Nishizawa S, Yokoyama T, Yokota N, Tokuyama T, Ohta S (2001) Incidentally identified syringomyelia associated with Chiari I malformations: is early interventional surgery necessary? Neurosurgery 49:637–640 (discussion 640–641)
Ozerdemoglu RA, Denis F, Transfeldt EE (2003) Scoliosis associated with syringomyelia: clinical and radiologic correlation. Spine 28:1410–1417
Paquis P, Lonjon M, Brunet M, Lambert JC, Grellier P (1998) Chiari type I malformation and syringomyelia in unrelated patients with blepharophimosis. Report of two cases. J Neurosurg 89:835–838
Paradis RW, Sax DS (1972) Familial basilar impression. Neurology 22:554–560
Retif J (1964) Synringomuelia and pharomatosis. Anatomoclinical study of 2 cases of Recklinghausen’s disease and 1 case of Hippel–Lindau’s disease, associated with syringomyelia. Acta Neurol Belg 64:832–851
Ritterbusch JF, McGinty LD, Spar J, Orrison WW (1991) Magnetic resonance imaging for stenosis and subluxation in Klippel–Feil syndrome. Spine 16:S539–S541
Rubinstein LJ (1986) The malformative central nervous system lesions in the central and peripheral forms of neurofibromatosis. A neuropathological study of 22 cases. Ann NY Acad Sci 486:14–29
Speer MC, Enterline DS, Mehltretter L, Hammock P, Joseph J, Dickerson M, Ellenbogen RG, Milhorat TH, Hauser MA, George TM (2003) Chiari type I malformation with or without syringomyelia: prevalence and genetics. J Genet Couns 12:297–311
Speer MC, George TM, Enterline DS, Franklin A, Wolpert CM, Milhorat TH (2000) A genetic hypothesis for Chiari I malformation with or without syringomyelia. Neurosurg Focus 8:Article 12
Spiegel DA, Flynn JM, Stasikelis PJ, Dormans JP, Drummond DS, Gabriel KR, Loder RT (2003) Scoliotic curve patterns in patients with Chiari I malformation and/or syringomyelia. Spine 28:2139–2146
Spillane JD, Pallis C, Jones AM (1957) Developmental abnormalities in the region of the foramen magnum. Brain 80:11–48
Stovner LJ, Cappelen J, Nilsen G, Sjaastad O (1992) The Chiari type I malformation in two monozygotic twins and first-degree relatives. Ann Neurol 31:220–222
Turgut M (2001) Chiari type I malformation in two monozygotic twins. Br J Neurosurg 15:279–280
Wild H, Behnert J (1964) Konkordante syringomyelie mit okzipito-zervikaler dysplasie bei eineiigem zwillingspaar. Munch Med Wochenschr 106:1421–1428
Wolpert C, Drake C, Speer M (2001) Genetic research for Chiari type 1 malformation and syringomyelia is well underway, vol. 2004 [Online]. Available at http://www.asap4sm.com/wolpert_drake_speer01.html. Accessed 11 July 2004
Yabe I, Kikuchi S, Tashiro K (2002) Familial syringomyelia: the first Japanese case and review of the literature. Clin Neurol Neurosurg 105:69–71
Yasuoka S, Takakura K (1983) Proposal for the definition of “foramen magnum syndrome”—foramen magnum tumor and abnormalities. No To Shinkei 35:1001–1007
Zakeri A, Glasauer FE, Egnatchik JG (1995) Familial syringomyelia: case report and review of the literature. Surg Neurol 44:48–53
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mavinkurve, G.G., Sciubba, D., Amundson, E. et al. Familial Chiari type I malformation with syringomyelia in two siblings: case report and review of the literature. Childs Nerv Syst 21, 955–959 (2005). https://doi.org/10.1007/s00381-005-1146-0
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-005-1146-0