Syringomyelia is defined as a condition of tubular cavitations within the spinal cord, lined by glial tissue. In theory it differs from hydromyelia, a dilatation of the central canal of the spinal cord, which is lined with ependyma. However, in practice the distinction between the conditions is often difficult to make; thus the term hydrosyringomyelia for all intraspinal cavities of a non-tumorous nature has been proposed. Hydrosyringomyelia is often associated with anomalies of the posterior fossa, the most common of which is Chiari type I malformation. In a few cases, an association of hydrosyringomyelia with isolated syncopal events has been described. These syncopes occurred especially in adult patients with associated Chiari type I malformation and were typically, but not in all cases, preceded by an increase in intrathoracic pressure caused by coughing, sneezing, or other exertion such as a Valsalva manoeuvre.1-3 Here, we report the case of a child with repeated syncopes, associated with hydrosyringomyelia/Chiari I malformation.

This 10 year old boy from Zaire was admitted for evaluation of syncope. This was the first episode; the syncope occurred while at rest at school. About one minute before the syncope, the patient experienced numbness of the left arm, occipital headache, and double vision, but no coughing, straining, or sneezing. Pallor of mucous membranes accompanying the syncope was not seen. Loss of consciousness lasted about five seconds, after which numbness of the arm …