Chiari Malformation Type 1 with cervicothoracic syrinx presenting as thumb necrosis: A case report

Finger necrosis has rarely been described as the presenting symptom of Chiari Malformation Type 1 (CM-1). We present a case of a 36-year-old man who presented with extensive thumb necrosis as the first presenting sign of a cervicothoracic syrinx in the setting of CM-1. The patient underwent debridement and partial amputation with groin flap coverage but subsequently developed additional neurological complaints of the left upper extremity. A suboccipital decompressive craniectomy, bilateral C1 laminectomy, and occipital duraplasty successfully relieved most of his symptoms. Healthcare professionals should consider CM-1 as a rare cause of finger necrosis.