Syringomyelia rarely accompanies hydrocephalus in the aged person except for the cases with a typical Chiari malformation. A 59-year-old woman developed progressive generalized weakness and gait disturbance for 9 years. MRI demonstrated marked enlargement of the cerebral ventricles and the longitudinal dilatation of central canal involving the entire spinal cord, whereas a typical Chiari malformation was absent. She was successfully treated by ventriculoperitoneal shunting. We report a hydrocephalic patient in her 50's accompanied by syringomyelia without a typical Chiari malformation.