ARNOLD – CHIARI MALFORMATION AND SYRINGOMYELIA
Generally, Arnold – Chiari malformation associated with syringomyelia is not rare. In this case report we present a 52 years old female patient with a history of neck-pain, low-back pain, pain in both arms as well as frequent numbness in the lateral regions of both arms. She also experienced walk disturbance and in her previous history she reports a car accident, twenty-eight years ago. She broke windshield with her forehead, but remained conscious at the time. At the time of admittance at the Department of Neurology, her neurological status was remarkable for cerebellar symptomatology (ataxia, positive Romberg-sign, «finger–nose» test which she did with tremor and was not able to perform «tandem-walk»), hypoestesia of the right side of the body, hyper-reflection of both arms and legs, bilaterally, more pronounced at the right side; right foot subclonus and spastic-ataxic walk. Neurological status could not be explained by previously performed tests: x-ray of cervical spine, lumbal myelography, computerized tomography (CT) of the brain. However, magnetic resonance imaging (MRI) of the brain and cervical spine verified Arnold-Chiari malformation (type I) associated with syringomyelia from C3 to C7. Patient was referred to surgery and subsequent physical rehabilitation.