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PubMed1986

Magnetic resonance imaging in syringomyelia.

The aim of the study was to assess the reliability of magnetic resonance imaging (MRI) in the detection of syrinx cavities and to determine the proportion of cavities associated with Chiari malformation. MRI was performed in over 120 patients with neurologic deficits referable to the cranio-cervical junction. Forty-one patients were also evaluated by CT myelography (CTM). CTM demonstrated appearances consistent with intramedullary cavitation in 14 patients. MRI detected 11 of these but in 3 the appearances, including cord size, were normal. In the entire study 27 syrinx cavities were demonstrated by MRI, 8 associated with trauma, posterior fossa or spinal tumours, or spinal dysraphism. Of the remaining 19, tonsillar ectopia was present in 10 (53%). It is concluded that a lack of concordance between MRI and CTM exists in the detection of small cavities in the normal sized cord, and that syringomyelia without evidence of tonsillar ectopia is identifiable by MRI more frequently than might be anticipated.

Adolescent↗
PubMed1988

[Suprasegmental autonomic regulation in syringomyelia patients and its alteration during radionuclide therapy].

Limbic-reticular dysfunction due to pathologic rearrangement in functional intracentral relations was evidenced in 85 syringomyelic patients. The dysfunction was initiated by the syringomyelic inflicted focus within the brainstem (syringobulbia) or spinal cord. Displayed were the psychoemotional, unspecific activational and hemodynamic correlates of this pathophysiological phenomenon. This is the first description of the radioactive iodine positive effect on limbic-reticular dysfunction in syringomyelia.

Adult↗
PubMed1988

[Clinico-morphological correlations based on MRI in syringomyelia. Study of 22 cases].

Twenty-two patients with syringomyelia were investigated clinically and by MR imaging using clearly defined clinical and radiologic protocols. Intramedullary cavities were identified by MR images in 20 cases and by CT scanning after intrathecal injection of Metrizamide in two cases. In all but one case, when the clinical picture was purely motor, concordance was established between clinical findings and morphologic type of intramedullary cavity. Syringomyelic syndromes should now be defined not only on the basis of clinical data but on clinicoradiologic features. The examination of choice is MR imaging, because of its reliability and safety and because it allows tridimensional analysis of cavities and associated malformations. Results of MR imaging exploration suggest a possible improved physiopathologic approach to the disease and more effective therapeutic procedures.

Adult↗
PubMed1988

[Skin changes in syringomyelia].

Asymmetric anonychia, skin edema, and painless ulceration of the fingers may be the first symptoms of syringomyelia. Neurologic examination of the patient leads to the diagnosis, which can be proved by the demonstration of the cavity in the central spinal cord. Prophylactic dermatologic treatment may prevent the progression of the skin lesions.

Biopsy↗
PubMed1987

[Early syringomyelia following benign cervical injury. Contribution of postoperative MRI].

The authors show an observation of a post traumatic syringomyelia syndrome which gradually developed a few months after a cervical sprain. The diagnosis has been mentioned after the discovery of a "big medulla" with myelography and computed tomography. The presence of a cervical cystic cavity with viscous liquid has been confirmed by surgery. A syringosubarachnoïd shunt has been carried out with excellent post operative results as the patient has recovered all his sensory and motor functions. For the pathogenic hypothesis mention is made of a small subclinic early hematomyelia which then develops on its own to form a genuine syringomyelic cavity. The authors emphasize the future interest of M.R.I. for the pathogenic diagnosis as well for the post operative effects.

Adult↗
PubMedDate not supplied

[Syringomyelia. Clinical and neurophysiologic correlations (SEP) as a function of surgical treatment].

The authors have studied the somatosensory evoked potential (SEP) behavior following stimulation of upper and lower limbs in two subjects affected by syringomyelia. The patients were evaluated electrophysiologically before and after decompressive surgical treatment. The findings indicate a positive correlation between the SEP recordings and the role of CSF pressure in the central nervous system.

Adult↗
PubMed1986

[Responsibility of the left renal vein and inferior vena cava in certain cases of myelitis and syringomyelia. Value of ligation of the venous reno-spinal trunk. Apropos of 30 cases].

Certain diffuse forms of myelitis may be due to raised intra-spinal venous pressure resulting in veritable "varicose veins of the spinal cord". The origin of this increased pressure is often multifactorial, but may be due to venous reflux of blood from the left kidney into the intraspinal plexuses via the reno-spinal trunk. Ligation of this trunk results in a considerable and often complete improvement in the neurological syndrome. This operation was performed for the first time by our team in 1973 and since then has been successfully performed on 30 occasions for 21 cases of myelopathy and 9 cases of syringomyelia.

Adult↗
PubMedDate not supplied

Delayed metrizamide CT enhancement of syringomyelia: postoperative observations.

Delayed metrizamide computed tomography (CT) was performed both preoperatively and postoperatively in 11 syringomyelia patients. Change of syrinx size between the studies was easily assessed on CT. The morphologic change of the syrinx gave useful information about its continuity. One of our cases had reoperation as a result of this CT information. All cases with Chiari I malformation still showed filling of the syrinx cavity by metrizamide after posterior fossa decompression and obex plugging. This supports the idea that the abnormal fluid circulation maintaining syringomyelic cavities is more than just the flow through the obex to the central canal but may also be from fluid passage through the cord substance.

Humans↗
PubMedDate not supplied

[Surgical treatment of communicating forms of syringomyelia].

Data concerning surgical intervention at the craniovertebral junction in 20 patients with the communicating form of syringomyelia are discussed. The method of a reconstructive operation is described. Positive changes of sensory and motor disorders were recorded in 14 patients after surgery, no changes occurred in 5 patients, one patient died. The expediency of maximum reconstruction of the posterior fossa with restoration of c.s.f. circulation from the cavity of the fourth ventricle is substantiated.

Adolescent↗
PubMed1985

Posttraumatic syringomyelia.

Posttraumatic syringomyelia can be a subtle entity initially. Awareness of the early clinical manifestations is a necessary adjunct in preventing the disabling sequela. Four case reports are examined with emphasis on temporal progression of symptoms and the resultant functional loss. The salient clinical features and a description of their pathogenesis are summarized. The presenting symptoms and signs were upper extremity reflex loss, musculoskeletal-type pain, and arm numbness. The functional impairments which resulted included the following: increased assistance with wheelchair mobility, significantly reduced performance of ADL, and loss of walking skill in a previously independent ambulator. Each patient underwent myelography (insufficient alone) as well as contrast CT scanning. Each patient underwent shunting with only one patient benefiting significantly. Syrinx formation must be included in the differential diagnosis of neuromuscular complaints by the spinal cord injured (SCI) population and treated appropriately.

Adolescent↗
PubMed1985

[Catamnestic findings in syringomyelia in the province of Padua].

While performing this research, 107 patients affected by syringomyelia were found, of which 35 were from the Padova province. The epidemiological study showed a progressive decrease of the disease in the last 40 years and a higher frequency in the rural area in comparison to the urban area. The data of prevalence in the region were also evaluated and compared with previous studies in other countries. The clinical studies, including a 20 years follow-up on a group of 25 patients, showed a slowly progressive impairment of the physical capacity without complete handicap, which had occurred in 2 of the group. The Authors suggest a constant clinical survey of these patients to encourage and support their social and professional activities.

Adult↗
PubMed1985

Hand, wrist, and elbow arthropathy in syringomyelia.

We present a patient with syringomyelia and neuropathic osteoarthropathy involving the elbow, wrist, and hand unilaterally and discuss the differential diagnosis of the radiographic features. The unique pattern of joint involvement in this patient may be explained by selective involvement of specific anatomic sites within the spinal cord.

Aged↗
PubMed1979

Syringomyelia presenting as a mass lesion of the conus medullaris.

A case is presented of a young girl with syringomyelia presenting as a mass lesion of the conus medullaris. Computerized tomography of the cerical spinal cord revealed asymptomatic extension of the syrinx to that level. Seven other similar cases are reviewed, and suggestions made for preoperative diagnosis of this unusual entity.

Adolescent↗
PubMed1965

Syringomyelia: a clinical review of 75 cases.

Records of 75 patients with syringomyelia are reviewed. Their clinical course fell into one of three main groups: (1) those with a long history of a steadily progressive disability; (2) those with a long history but little or no progression of their disability; and (3) those with a short, fairly rapid downhill course.On the basis of this study, x-ray therapy seems to be of little value in the treatment of this disease. Surgical treatment on the other hand appears to offer more hope for a selected group of patients who are progressing at the time of examination. In this group surgery is recommended (1) in the presence of a foramen magnum anomaly with signs and symptoms related to this deformity; (2) in the presence of a distended cord with pain and evidence of a spinal fluid block; and (3) when the possibility of an ependymoma exists.

Adolescent↗
PubMed1980

[Pathogenesis of the acromegalic syndrome in syringomyelia].

Clinical observations of 90 patients suffering from syringomyelia revealed growth defects frequent with this pathology, such as, short height, acromegalia, macrosomia, cheiromegalia, costal hump. Hormonal examinations with determination of the growth hormone content in the blood carried out by functional tests confirmed the frequently observed disturbance of the somatotropic function of the hypophysis in syringomegalic patients. The leading role of the change of the hypothalamus functional state and the disturbance of the hypothalamohypophysial interrelations were revealed. Distinctions are made between cerebral acromegalia which is due to an affection of the diencephalon and is combined with other metabolo-endocrinal disorders, and segmental acromegaly developing within the zone of impaired innervation because of frequent affections of the spinal cord, disturbances of the trophics, and increase of the sensitivity of the peripheral tissue receptors to the growth hormone.

Acromegaly↗
PubMedDate not supplied

Percutaneous injection of metrizamide into spinal cord cysts for preoperative diagnosis of syringomyelia.

Five cases of syringomyelia are reported in which the spinal cysts were percutaneously punctured and filled with metrizamide for preoperative diagnosis. There were no side effects from the puncture or the contrast medium. In all cases the cyst was larger than had been demonstrated by previous myelography. A communication to the fourth ventricle was seen in two cases. Four patients had surgical treatment; the neurologic deficits improved in two patients, while the condition of the others has remained unchanged.

Humans↗
PubMedDate not supplied

Radiography of posttraumatic syringomyelia.

Posttraumatic syringomyelia was studied in 15 patients. Gas myelography in 12 patients showed a definite spinal cord swelling in 10 and a probable cord enlargement in two. Plain spinal computed tomography (CT) in four patients demonstrated intramedullary radiolucent zones in three. After intrathecal injection of metrizamide in 10 patients, cysts were opacified in eight. Postoperative CT in two patients demonstrated collapse of the cyst in one. Gas myelography shows the extent and site of maximal dilatation of the cyst where a shunt can be placed. CT is less invasive and provides a definitive diagnosis.

Adult↗
PubMed1984

[A case report of post-traumatic syringomyelia].

A case of posttraumatic syringomyelia which appeared 26 years after the injury was presented. A patient was 61 year old female, who sustained thoraco-lumbar spine injuries rendering her to paraplegic in 1954. Eleven months later she had an operation of T6-T9 and L1-L2 laminectomies and regained motor and sensory functions of the both lower extremities. She was ambulatory with crutches till 1979. In 1980, burning pain was noticed in the left scapular region, and thereafter, extended to the ulnar side of the left forearm. The pain became progressively worse and intractable. Analgesics were ineffective. Two years later muscle atrophies and weakness in the left finger intrinsic muscles appeared. Absent deep tendon reflexes in the left upper extremity, dissociated sensory loss (in the left C2-S1 and right T5-T12 dermatomes) and paraparesis were also documented. Metrizamide CT scan performed 24 hours after the intrathecal injection disclosed an intramedullary syrinx between C2 and L1 vertebral levels. No communication with the fourth ventricle was seen. A syringoperitoneal shunt with low pressure valve was placed. The pain subsided immediately after this procedure. However, no improvement in motor and sensory functions were observed. Pathophysiological mechanisms involved in post-traumatic syrinx formation and its development were discussed. We prefer hypothesis proposed by Ball and Dayan to Gardner's hydrodynamic theory regarding to development of the syrinx secondary to spinal cord injury.

Female↗