An 11-year-old girl with Chiari I malformation presented with a large cervico-thoracic syrinx (Fig. 1). There was poor clinical improvement 4 months after foramen magnum decompression. Subsequently, syringosubarachnoid shunting was performed, resulting in complete resolution of the syrinx and marked clinical improvement. The shunt was seen as a small tubular structure on MRI, with prominent flow artifact within the thecal sac near the shunt opening (Fig. 2). Syringomyelia associated with Chiari I malformation can be treated by foramen magnum decompression, syringosubarachnoid shunting and syringoperitoneal shunting [1, 2]. Syringosubarachnoid shunting is a safe, effective and techni
