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PubMed1981

Syringoperitoneal shunt for syringomyelia: a preliminary report.

Syringoperitoneal shunting has been used in the treatment of 4 patients with idiopathic syringomyelia. The procedures have been performed without morbidity or mortality. Postoperative observation, ranging from 7 to 23 months, has not revealed progression of symptoms or failure of the shunt. The pathophysiological theories of syringomyelia are discussed, and various surgical procedures for syringomyelia are reviewed and their results compared to the effectiveness of the syringoperitoneal shunt.

Adult↗
PubMed1985

Syringomyelia associated with a foramen magnum meningioma.

In a 14-year-old boy with a meningioma at the foramen magnum extending to C-2, cervical syringomyelia was found on metrizamide computed tomographic myelography. The mechanism of syrinx enhancement on delayed computed tomographic scanning was considered to be due to transneural passage of metrizamide into the spinal cord. Long-standing spinal block may be responsible for development of syringomyelia. Syringomyelia associated with spinal extramedullary tumors was reviewed in the literature.

Adolescent↗
PubMed1989

Surgical treatment of syringomyelia: favorable results with syringosubarachnoid shunting.

The authors review the clinical course of 29 patients who underwent syringosubarachnoid shunting for syringomyelia. Twenty-two patients presented hindbrain-related syringomyelia; seven patients had non-hindbrain-related syringomyelia secondary to trauma (four cases) and to spinal arachnoiditis (three cases). The surgical technique is described in detail. All patients showed postoperative deflation or collapse of the syrinx at follow-up magnetic resonance imaging evaluation. Symptoms stabilized in 17 cases (59%); 9 cases (31%) showed improvement in the neurological function; 3 cases (10%) presented delayed neurological deterioration, probably owing to spinal cord ischemia.

Adolescent↗
PubMed1995

Syringomyelia secondary to tonsillar herniation caused by posterior fossa tumors.

BACKGROUND: A number of patients diagnosed as having syringomyelia secondary to tonsillar herniation caused by posterior fossa tumors has recently been described, although the backgrounds of the affected patients were not studied. In order to determine the possible causative contribution of the tonsillar herniation, the present cooperative study was carried out. METHODS: A retrospective study was performed by five cooperating institutes. Magnetic resonance images (MRIs) of patients with posterior fossa tumors were reevaluated with particular attention to the existence of tonsillar herniation and syringomyelia. RESULTS: The total number of patients with posterior fossa tumors whose MRIs were reinvestigated was 164. In 24 out of the 164 patients, tonsillar herniation was apparent in the sagittal plane of the MRI. Syringomyelia was observed in five of the 24 cases with tonsillar herniation being a consistent associated finding. None of the individuals demonstrated any sensory disturbance directly corresponding to the syrinx formation. All but one of the five patients underwent surgical removal of the tumor, but no one required surgical treatment for the syrinx itself. Disappearance or shrinkage of the syrinx could be confirmed by postoperative MRIs in three of them. CONCLUSIONS: A simple mechanism of blockage of cerebrospinal fluid flow at the foramen magnum may play an important role in syrinx formation, as evidenced by the unexpectedly high incidence of cervical syrinx along with tonsillar herniation caused by posterior fossa tumors shown in the present study.

Adolescent↗
PubMed2005

Trigeminal neurinoma associated with Chiari malformation and syringomyelia.

We report a 36 year-old woman who presented with headaches and hypoesthesia of the face. MRI revealed a large dumbbell shaped trigeminal neurinoma extending into both the middle and the posterior cranial fossae. In addition, there was a Chiari I malformation and syringomyelia. Within two months of tumor resection, both the Chiari malformation and the syringomyelia resolved. The association of an intracranial space-occupying lesion with Chiari malformation and syringomyelia is reviewed.

Adult↗
PubMed2002

Familial syringomyelia: the first Japanese case and review of the literature.

We reported on syringomyelia in a mother and her son. The mother was 74-year-old, who developed gait difficulty at the age of 54. The son, 47-year-old, developed the same symptoms at the age of 35. In the both cases, MRI revealed syringomyelia with Chiari malformation. Twenty-one families with syringomyelia have been reported. The existence of these families indicates that genetic factors may play in role to the pathogenesis of this disorder.

Aged↗
PubMed1989

Association of ganglioneuroblastoma with syringomyelia. Case report.

The association of a syndrome of a degenerative nature such as syringomyelia and a neuroblastoma can be of clinical interest. We will describe the case of a young female suffering from a retroperitoneal neuroblastoma and secondary development of syringomyelia. The possible pathogenetic link between these two pathologies will be discussed. Firstly, the dysontogenetic interpretation will be underlined. Other hypotheses will concentrate on the presence of tumors within the cord, which tend to cavitate, and furthermore, on the association between the edema and some diseases such as neoplasma, traumas, and on arachnoiditis as a major pathogenetic factor in syringomyelia. The existence of a possible link between arachnoiditis and the radiotherapy received by the patient after the surgical excision of the retroperitoneal neuroblastoma, will be discussed. Lastly a further pathogenetic hypothesis will be pointed out: an intramedullary softening due to disturbed blood supply, caused by the extramedullary neoplasm.

Adolescent↗
PubMed1998

[Correlations between clinical deficits, motor and sensory evoked potentials and radiologic aspects of MRI in malformative syringomyelia. 27 Cases].

Twenty-seven patients (15 males, 12 females, age range: 16-66 years) were admitted for malformative syringomyelia diagnosed on MRI with measures of syrinx extending and transverse diameter. Posterior tibial somatosensory evoked potentials (PT SEP), median (M SEP), trigeminal (V3 SEP), brain stem auditory evoked potentials (BEAP), cortical and cervical motor evoked potentials (MEP) were correlated with clinical and radiological findings. SEP abnormalities were not correlated with the duration of symptoms. PT SEP proved to be more sensitive than M SEP. MEP abnormalities were very frequent (87% of the cases), even without clinical motor deficits. Trigeminal SEP were more sensitive than BEAP which were not related to the presence of associated cranio-vertebral abnormalities. We found no significative relationship between clinical and radiological results. Moreover, there was a positive relationship between electrophysiological and radiological results: abnormal trigeminal SEP were detected in 85% of the patients with high cervical syringomyelia. In all cases, trigeminal SEP and MEP should be done in association with M and PT SEP as both of them detect subclinical evidence of spinal cord dysfunction in syringomyelia.

Adolescent↗
PubMed1994

Post-traumatic syringomyelia: a review of the literature.

The need for increased awareness and a high index of suspicion for post traumatic syringomyelia is emphasised. Early clinical diagnosis confirmed by MRI and early treatment can avert or minimise the potentially devastating effects of post traumatic syringomyelia. The regular and frequent follow up of the patient on a yearly or alternate year basis to monitor the patient with spinal injury for this complication, as well as other complications, is the best way to ensure that post traumatic syringomyelia is diagnosed and managed early in order to avoid further disability.

Humans↗
PubMed1995

Mean term follow-up of a series of post-traumatic syringomyelia patients after syringo-peritoneal shunting.

We report the follow-up of a series of post-traumatic syringomyelia patients treated by syringo-peritoneal shunting (SPS). The neurological status was determined following the international ASIA/IMSOP standards for neurological classification of spinal cord injury; this was completed by a modified Silberstein classification that identifies the ascending neurological symptoms as well as the increasing myelopathic symptoms in patients with post-traumatic syringomyelia. Magnetic resonance imaging (MRI) was systematically performed to assess the presence of a postoperative residual syrinx or of meningeal fibrosis. Eight patients were studied (five men, three women) with an age ranging from 17 to 54 years (mean of 30.7 years) at the time of the spinal cord injury. Three had a complete or nearly complete paraplegia, five were incomplete. The post-traumatic syringomyelia was diagnosed from 2 to 8 years after the spinal cord injury and was treated by syringo-peritoneal shunting. Early complications occurred in three patients: (1) displacement of the catheter, (2) obstruction of the catheter, and (3) haematomyelia, which disappeared after a new surgical procedure was performed. The postoperative follow-up ranged from 3 to 9 years (mean of 4.5 years). The neurological level decreased in every case and the ascending neurological symptoms decreased or were stabilised in seven patients. The postoperative ASIA/IMSOP scores and the increasing myelopathic symptoms improved in four patients but worsened in the four others, incomplete. The MRI showed an important decrease of the syrinxes in every patient associated with a serious meningeal fibrosis in five cases. Syringo-peritoneal shunting seems to be efficient in the treatment of the syrinx but may have a poor effect regarding the prevention of meningeal fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2001

Surgical management of syringomyelia associated with spinal adhesive arachnoiditis.

The authors describe a new surgical technique to minimise the postoperative recurrence of adhesion after microlysis of adhesion to treat syringomyelia associated with spinal adhesive arachnoiditis. A 47 year old male presented with numbness of the lower extremities and urinary disturbance and was demonstrated to have a case of syringomyelia from C1 to T2 which was thought to be secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis. Following meticulous microlysis of the adhesions, maximal expansion of a blocked subarachnoid space was performed by expansive duraplasty with a Gore-Tex surgical membrane, expansive laminoplasty and multiple tenting sutures of the Gore-Tex graft. Postoperatively, the syringomyelia had be en completely obliterated and improvement of the symptoms had been also achieved. The technique described may contribute to improvement of the surgical outcome following arachnoid dissection by maintaining continuity of the reconstructed subarachnoid space.

Arachnoiditis↗
PubMed2005

Chiari I malformation with or without syringomyelia and pregnancy: case studies and review of the literature.

Women with Chiari I malformation with or without syringomyelia are of particular concern because of the potential risk of increased intracranial pressure during pregnancy and delivery. The following questions are most often asked in the clinical setting: Is it safe to have a planned pregnancy? Will the symptoms become worse or recur during pregnancy and will the baby be normal? Seven patients with Chiari I malformation, with and without syringomyelia, submitted checklists of self-reported symptoms experienced during pregnancy, labor, and postpartum. Seven patients with Chiari I malformation with and without syringomyelia were queried for symptoms during pregnancy, labor, and postpartum. None of the patients reported significant increase or recurrence of Chiari-related symptoms during delivery or postpartum. Four of the women had epidural anesthesia for delivery and reported no related symptoms. This series represents a small number of women with Chiari I malformation who had uncomplicated pregnancy, labor, and delivery.

Adult↗
PubMed1990

[Atypical forms of syringomyelia--a case report].

The introduction of magnetic resonance imaging (MRI) has made the diagnosis of syringomyelia safer and more exact. Moreover, the lack of correlation between the clinical picture and the MRI findings was demonstrated, and unsuspected cases could be identified as pertaining to syringomyelia. The three cases reported should point at the variable symptomatology in syringomyelia. A more frequent occurrence of unusual symptoms and courses of the disease than previously assumed is discussed.

Adult↗
PubMedDate not supplied

[Scoliosis as a concomitant disease of syringomyelia].

Three long-time and two ore three respectively shorter observations of scoliotics with syringomyelia are presented and the pertinent literature is discussed including the complex etiopathogenesis. An attempt is made to describe the concomitant scoliosis. The older the patients with syringomyelia so more frequently scolioses appear, up to about two thirds of all cases, resembling a deformity due to paralysis: Dorsal kyphoscoliosis with lumbar countercurve and lordosis, tendency towards a list of the trunk, eventually rapid progression not only in the growing age but also in adulthood. The scoliosis may preceed the neurologic symptoms for years as well as follow later. Spontaneous fusion of the curves may occur by broad based flat bony appositions to the vertebrae with round prominences as well, aetiologically probably due to syringomyelia: "dystrophic". Since the spinal cord of these cases is more ore less pre-damaged and does react very sensible to progression of the scoliosis, in this phase mainly laminectomy for decompression is indicated whereas treatment otherwise is administered with the help of a Milwaukee brace. If one decides exceptionally to perform a fusion operation the application of any essentional distraction force and contusion is to be avoided.

Adolescent↗
PubMed1988

[Syringomyelia: correlation of magnetic resonance tomographic and clinical findings before and after surgery].

A comparison between clinical and MRI findings in 20 patients with syringomyelia produced the following results: 1. The position and extent of the syrinx do not correspond with the clinical findings. 2. Successfully operated syringomyelia cavities collapse in their sagittal diameters. The resulting oval shape of the syrinx can be used to evaluate shunt insufficiency. 3. In almost half of the patients, the diameter of the spinal cord is within the 95th percentile of normal controls and would therefore not have been diagnosed by myelography. 4. Anomalies of the cranio-cervical junction were present in only one-third of the patients. This finding does not support the hypothesis that syringomyelia is caused by hydrodynamic factors only.

Adult↗
PubMed1995

Intraoperative monitoring of median nerve somatosensory evoked potentials in cervical syringomyelia: analysis of 28 cases.

Intraoperative median nerve somatosensory evoked potentials (SEP) were monitored in 28 patients undergoing surgery for cervical or cervicothoracic syringomyelia. Analysis was focused on SEP components N13 (spinal cord), P14 (brain stem), and N20 (cortex). N13 was lacking in nearly 87% of the patients (due to a combined effect of syringomyelia and general anesthesia) and never recovered. P14 showed a significant (> 10%) intraoperative latency increase in two patients; this was irreversible in one patient who had a postoperative worsening of sensory function. N20 showed no relevant alterations. Pure motor deficits after surgery were not predicted by SEP monitoring. In conclusion, intraoperative P14 recording helped to identify harm to the dorsal columns and probably prevented the cord from irreversible damage in one case, whereas N13 recording did not contribute to the monitoring of spinal cord function during surgery for syringomyelia.

Adult↗
PubMed1999

Syringo-subarachnoid shunt for syringomyelia using partial hemilaminectomy.

Syringo-subarachnoid shunt (S-S shunt) is one of the established surgical procedures for syringomyelia. However, this procedure requires a laminectomy which may lead to spinal column complications. We present a modified form of S-S shunt using a partial hemilaminectomy; a S-S shunt is placed via the dorsal root entry zone into the anterior subarachnoid space which is considered to be an ideal site for the drainage of the syrinx fluid. This technique will decrease the incidence of neuronal and spinal complications after surgery and avoid subarachnoid adhesions around the shunt tube. Between 1992 and 1997, a total of 24 patients with syringomyelia have been treated with this surgical procedure without any complications. Collapse of the syrinx was achieved in all cases. The authors believe that the procedure is an effective surgical treatment for syringomyelia and can be applied safely to adolescent and child cases.

Adolescent↗
PubMed1999

The treatment dilemma in post-traumatic syringomyelia.

PURPOSE: The aim of the present study was to compare the functional effect of conservative and surgical treatment in post-traumatic syringomyelia. METHOD: The files of 10 male patients treated for posttraumatic syringomyelia were retrospectively reviewed from 1986 to 1996. RESULTS: The spinal lesion was complete in five patients and incomplete in five. All patients underwent rehabilitation, five of them following surgery. The operative procedures included drainage by syringosubarachnoid shunting (four patients) and decompressive laminectomy (one patient). Rehabilitation alone improved the functional status in all five patients so treated. After surgery, function deteriorated in four of the five operated patients, and rehabilitation failed to restore the preoperative functional status in any of them. CONCLUSION: In view of the results it is suggested that patients with post-traumatic syringomyelia undergo rehabilitation with very close clinical and magnetic resonance imaging follow-up.

Adolescent↗