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Syringomyelia or syrinx is a fluid-filled cavitation within the spinal cord that can produce symptoms of progressive myelopathy.1 Standard of care for large, symptomatic lesions involves direct surgical intervention. Here, we present a case of a woman who achieved spontaneous resolution of her cervicothoracic syrinx after significant weight loss.
A morbidly obese 42-year-old woman with body mass index (BMI) of 52 kg/m2 presented with months of progressive radiating pain to the hands. The patient described intermittent paresthesia and loss of temperature sensation in the left-greater-than-right hands. She had slight incoordination and weakness of the left hand, but was otherwise motor intact. She denied issues with gait instability or bowel/bladder incontinence. She had no antecedent history of trauma nor vision loss/symptoms of idiopathic intracranial hypertension (IIH).
MRI of the cervical, thoracic and lumbar spine without contrast revealed a large, cervical and thoracic syrinx, measuring 14 mm in the greatest diameter (figure 1). Notably, she had no Chiari malformation. MRI of the brain, cervical, thoracic and lumbar spine with contrast as well as cerebrospinal fluid (CSF) flow imaging sequencing demonstrated no occult neoplasms, arachnoid webs, nor intracranial lesions.
Contributors Each named author has substantially contributed to conducting the underlying research and drafting this manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests To the best of our knowledge, the named authors have no conflict of interest, financial or otherwise.
Provenance and peer review Not commissioned; externally peer reviewed.
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