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MR imaging of spinal cord hemangioblastoma associated with syringomyelia.

A case of isolated spinal cord hemangioblastoma with associated extensive syringohydromyelia, which was evaluated by myelography, postmyelographic CT, magnetic resonance (MR), and angiography is presented. The specific preoperative and postoperative advantages of MR are given as well as a brief review of the literature.

Adult↗
PubMed1990

Syringomyelia presenting as cricopharyngeal pseudostricture.

A 14-year-old boy was referred for evaluation of a cervical esophageal "stricture" diagnosed by upper gastrointestinal radiograph, which had been performed for evaluation of dysphagia and dysphonia of several months' duration. Neurological examination revealed several cranial nerve abnormalities and hyperreflexia, raising the suspicion of a cervicomedullary junction lesion. However, computed tomography of the head, neck, and spine was completely normal. Findings on the swallowing videofluoroscopy were interpreted as consistent with a stricture (a "tight constriction distal to the pyriform sinus"). However, no evidence for this was found by either esophagoscopy or esophageal manometry, which revealed a low-pressure cervical esophageal sphincter. Neurologic evaluation was pursued with magnetic resonance imaging, which revealed a large syrinx extending from C2 to T2 segments. We report this case to point out the importance of considering neurologic disease in the differential diagnosis of "stricture" of the cervical esophagus.

Adolescent↗
PubMed1988

Clinical and experimental studies on permeability of tracers in normal spinal cord and syringomyelia.

Delayed CT Myelography (CTM) demonstrated intramedullary cavities in 18 patients, most of which appeared on the 6-hour scan. The attenuation values of the normal spinal cord increased progressively with time, and recorded a peak at 6 hours. The CT numbers of the gray matter of metrizamide were significantly high, as compared with those of iotrol. In the tracer study reported, lanthanum penetrated through the marginal glia to the normal and pathologic spinal cord. Reaction products of horseradish peroxidase (HRP) were mainly in the extracellular space of the normal spinal cord. The pathologic spinal cord, however, allowed the passage of HRP into the parenchyma through the extracellular space of the marginal glia. Consequently, the extracellular space of the spinal cord surface constitutes a pathway for cerebrospinal fluid solutes. Either metrizamide or iotrol thus diffuses into the spinal cord from the subarachnoid space.

Animals↗