[The relation between fibrous dysplasia of bone (Jaffe-Lichtenstein disease) and syringomyelia].
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A hydrocephalic-hydromyelic condition was induced in adult cats by causing the closure of the lateral apertures with intracisternal injections of kaolin. After displaying the symptoms characteristic of increased intracranial pressure, which lasted about 10-14 days but varied somewhat in intensity from animal to animal, the cats recovered. From approximately the 2nd post-operative week onward, a distended central canal was revealed by ventriculography; subsequently cavities developed in the tissue of the cord that communicated with the canal. Most cavities were located dorsal to the canal. The surfaces of the distended canal and the cavities showed that in ventral areas the ependyma streched but remained intact, whereas in dorsal areas it ruptured, exposing the nerve fibers to the cerebrospinal fluid (CSF). In cats which had been hydrocephalic for up to 2 years the walls of the cavities were covered by gliotic scar tissue; the nerve fibers were no longer exposed directly to the CSF.
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We describe a patient with a presumed intramedullary tuberculoma treated only with antituberculous therapy. MRI showed a ring-enhancing annular lesion in the thoracic spinal cord with a distant syringomyelic cavity, which improved after therapy. MRI in this case allowed us not only to achieve a presumptive diagnosis but also to assess the therapeutic response, making surgical exploration unnecessary.
INTRODUCTION: The diagnosis of Chiari I malformation relies mainly on the anatomical demonstration of the abnormal position of the cerebellar tonsils below the foramen magnum, and of the associated bony anomalies of the posterior cranial fossa and craniocervical junction, as well as of the eventually-associated spinal cord cavitations. Consequently, the neuroradiological work-up plays a fundamental role in the definition of the malformation and in the follow-up of operated patients. REVIEW: The authors review the pertinent literature on the neuroradiology of the Chiari I malformation, with special regard to MRI, with the aim of providing the reader with an updated instrument for its diagnosis.
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We describe a patient who has been complaining of brief jerk-like, rhythmic, involuntary movements involving the second digit of the left hand for the last three months. These involuntary jerks produced an adduction movement of the second digit and were unaffected by peripheral sensory stimuli. In addition, the patient experienced loss of dexterity in the left hand. On examination the patient showed hypotrophy of the first dorsal interosseous (FDI) muscle of the left hand and a dissociated sensory loss involving the C8-T1 dermatomes. Magnetic resonance imaging of the brain and spinal cord revealed a tonsilar hemiation characteristic of the Chiari I malformation associated with a syrinx extending from C4 to D5 that did not communicate with the fourth ventricle. The electrophysiological evaluation indicated the presence of a focal myoclonus of spinal origin that is likely to be caused by the syrinx.