Partially calcified giant hemorrhagic syringomyelia and hematomyelia

Syringomyelia is a rare condition characterized by the formation of a fluid-filled cyst within the spinal cord, leading to myelopathy. In addition, the pathological enlargement of the central canal is referred to as hydromyelia or cleft-like syrinx. We present a case of idiopathic syringomyelia and hematomyelia in a 50-year-old female patient with a 5-year follow-up on her disease progression. Magnetic resonance imaging (MRI) images revealed low-signal intensity on T1 and high-signal intensity on T2, with elevated hemorrhagic signal intensity on T1 and low peripheral signal intensity on T2. A fluid-filled lesion measuring 12 × 36 mm was observed between the C7 and Th3 vertebrae, with separation from some of the detailed components. No contrast enhancement was noted following IV contrast administration. Based on the MRI findings, a diagnosis consistent with giant hemorrhagic syringomyelia was established. Subsequently, a neurosurgical intervention was performed, resulting in a reduction in the size of the syringomyelia and a moderate improvement in the patient's symptom profile.