Donald Davis

12/4/17 Radiology Case Extra Credit

The article was a case study of a 14-year-old boy who was admitted to the hospital with
intermittent pain and numbness in the right upper limb. Pt. also had urinary frequency, neck pain, back
pain, and numbness simultaneously. MRI showed a Chiari Type 1 malformation, syringomyelia, small fat
deposit in the filum at the L2 vertebral body level, and the conus medullaris at the L1 vertebral level
resulting in occult tethered cord syndrome. In this case the patient underwent surgical sectioning of the
filum terminale during his first hospital stay, and a posterior fossa decompression 190 days later in his
second hospital stay. After the first surgery, the patient had relief of pain in his right upper limb, but still
had complaints of numbness. Pt. had relief of numbness after the second surgery. The imaging showed
corresponding improvement in the CM1 and reduced syringomyelia after 6months. The reimaging at 18
months showed further improvements.