Spontaneous resolution of idiopathic syringomyelia

To the Editor: Kastrup et al.1 have reported an adult case of idiopathic syringomyelia with spontaneous resolution of a syrinx. Their article is valuable in so far as it offers a policy of care for patients with syringomyelia while helping us to understand the mechanism by which a syrinx is formed and maintained, but their discussion falls short. They speculate that spontaneous decompression of the syrinx occurred as a result of a tear in the spinal cord. Although they mention that improvement of the flow of the CSF around the foramen magnum carried by the improvement of the Chiari malformation can result in spontaneous resolution of the syrinx, they pay insufficient attention to the location and shape of the cerebellar tonsils. In 1990, we reported spontaneous resolution of the syrinx, and speculated that improvement of flow of CSF …