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Gaziosmanpasa Universitesi Tıp Fakültesi, Beyin ve Sinir Cerrahisi, Tokat, Turkey We present a 41-year-old man with Chiari type 1 malformation and cervical syringomyelia. Although the tonsillar herniation persisted, his syringomyelia was almost completely resolved during an eleven-year time period without surgery. Keywords : Chiari type 1 malformation, Syringomyelia, Treatment, Pathogenesis