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Journal of Veterinary Internal Medicine May 2022Hydromyelia is a common magnetic resonance imaging (MRI) finding associated with compressive myelopathy caused by intervertebral disc extrusion (IVDE).
BACKGROUND
Hydromyelia is a common magnetic resonance imaging (MRI) finding associated with compressive myelopathy caused by intervertebral disc extrusion (IVDE).
OBJECTIVES
To describe the MRI features of hydromyelia and explore its relationship to clinical history, neurological severity, and the duration of cord compression.
ANIMALS
Ninety-one client-owned dogs with a focal compressive myelopathy secondary to thoracolumbar IVDE.
METHODS
A retrospective observational study was conducted in which MRIs were blindly evaluated to grade and localize hydromyelia and measure the degree of spinal cord compression. Duration and severity of clinical signs were recorded. Differences between hydromyelia grades in these variables were statistically assessed using a Wilcoxon and Kruskal Wallis test. Receiver operator curve analysis was used to determine the sensitivity and specificity for duration of clinical signs to predict the presence of hydromyelia.
RESULTS
Hydromyelia was identified at sites of IVDE in 84 of 91 dogs. An absence of hydromyelia was associated a with statistically longer duration of clinical signs (mean 73.1, IQR 76 days) when compared to cases with mild (mean 17.7, IQR 7.25 days, P = .006) or severe (mean 17.9, IQR 10.25 days, P = .006) hydromyelia. Duration of clinical signs <14 days was 78.6% sensitive and 85.7% specific for predicting the presence of hydromyelia.
CONCLUSIONS AND CLINICAL IMPORTANCE
The MRI finding of hydromyelia might be a predictor of lesion chronicity in focal IVDE, helping to guide planning of hemilaminectomy surgery.
Topics: Animals; Dog Diseases; Dogs; Intervertebral Disc; Intervertebral Disc Displacement; Laminectomy; Magnetic Resonance Imaging; Retrospective Studies; Spinal Cord Compression
PubMed: 35481715
DOI: 10.1111/jvim.16433 -
Journal of Craniovertebral Junction &... 2023Subarachnoid hemorrhage (SAH) is a serious pathology with a high death and morbidity rate. There can be a relationship between hydromyelia and hydrocephalus following...
OBJECTIVES
Subarachnoid hemorrhage (SAH) is a serious pathology with a high death and morbidity rate. There can be a relationship between hydromyelia and hydrocephalus following SAH; however, this subject has not been well investigated.
MATERIALS AND METHODS
Twenty-four rabbits (3 ± 0.4 years old; 4.4 ± 0.5 kg) were used in this study. Five of them were used as the control, and five of them as the SHAM group. The remaining animals ( = 14) had been used as the study group. The central canal volume values at the C1-C2 levels, ependymal cells, numbers of central canal surfaces, and Evans index values of the lateral ventricles were assessed and compared.
RESULTS
Choroid plexus edema and increased water vesicles were observed in animals with central canal dilatation. The Evans index of the brain ventricles was 0.33 ± 0.05, the mean volume of the central canal was 1.431 ± 0.043 mm, and ependymal cells density was 5.420 ± 879/mm in the control group animals ( = 5); 0.35 ± 0.17, 1.190 ± 0.114 mm, and 4.135 ± 612/mm in the SHAM group animals ( = 5); and 0.44 ± 0.68, 1.814 ± 0.139 mm, and 2.512 ± 11/mm in the study group ( = 14). The relationship between the Evans index values, the central canal volumes, and degenerated ependymal cell densities was statistically significant ( < 0.05).
CONCLUSIONS
This study showed that hydromyelia occurs following SAH-induced experimental hydrocephalus. Desquamation of ependymal cells and increased cerebrospinal fluid secretion may be responsible factors in the development of hydromyelia.
PubMed: 37860031
DOI: 10.4103/jcvjs.jcvjs_67_23 -
Journal of Clinical Medicine Oct 2022Purpose: Once believed a result of pathophysiological correlations, the association between Chiari 1 malformation (CM1) and epilepsy has since been considered as a...
Purpose: Once believed a result of pathophysiological correlations, the association between Chiari 1 malformation (CM1) and epilepsy has since been considered as a coincidence, due to missing etiologic or clinical matching points. At present, the problem is being newly debated because of the increasing number of CM1 diagnoses, often among children with seizures. No specific studies on this topic are available yet. The present study aimed at updating the information on this topic by reporting on a series of children specifically enrolled and retrospectively analyzed for this purpose. Methods: All children admitted between January 2015 and June 2020 for epilepsy and CM1 were considered (Group 1). They were compared with children admitted in the same period for symptoms/signs related to CM1 and/or syringomyelia (Group 2). Syndromic patients were excluded, as well as those with tumoral or other overt intracranial lesions. All patients received a complete preoperative work-up, including MRI and EEG. Symptomatic children with CM1/syringomyelia were operated on. The pertinent literature was reviewed. Results: Group 1 was composed of 29 children (mean age: 6.2 years) showing CM1 and epilepsy with several types of seizures. A share of 27% had CM1-related symptoms and syringomyelia. The mean tonsillar ectopia was 7.5 mm. Surgery was performed in 31% of cases. Overall, 62% of children are currently seizure-free (including 5/9 children who were operated on). Tonsillar herniation and syringomyelia regressed in 4/9 cases and 4/8 cases, improved in 4/9 cases and 3/8 cases, and remained stable in 1/9 and 1/8 cases, respectively. CM1 signs/symptoms regressed completely in 6/8 cases and improved or remained stable in one case in each of the two remaining patients. Group 2 consisted of 77 children (mean age: 8.9 years) showing symptoms of CM1 (75%) and/or syringomyelia (39%). The mean tonsillar ectopia was 11.8 mm. Non-specific EEG anomalies were detected in 13 children (17%). Surgery was performed in 76.5% of cases (18 children were not operated on because of oligosymptomatic). Preoperative symptoms regressed in 26%, improved in 50%, remained stable 22%, and worsened in 2%; CM1 radiologically regressed in 39%, improved in 37%, remained unchanged in 22%, and worsened in 2%; and syringomyelia/hydromyelia regressed in 61%, improved in 30%, and was stable in 9%. No statistically significant differences between the two groups were detected regarding the M/F ratio, presence of syringomyelia/hydromyelia, or CM1/syringomyelia outcome; moreover, no correlation occurred between seizure-free condition and PF decompression in Group 1, or between disappearance of EEG anomalies and PF decompression in Group 2. A significant difference between the two groups was noticed regarding the mean age at admission (p = 0.003), amount of tonsillar herniation (p < 0.00001), and PF decompression (p = 0.0001). Conclusions: These findings do not support clinical correlations between CM1 and epilepsy. Their course depends on surgery and antiepileptic drugs, respectively. The analysis of the literature does not provide evidence of a relationship between seizures and cerebellar anomalies such as CM1. Rather than being linked to a syndrome that could explain such an association, the connection between the two now has to be considered to be random.
PubMed: 36294502
DOI: 10.3390/jcm11206182 -
Lancet (London, England) Sep 1977Seven consecutive patients with compressive cervical myelopathy were studied with standard water-soluble contrast myelography and immediate CT followed by delayed CT of...
Seven consecutive patients with compressive cervical myelopathy were studied with standard water-soluble contrast myelography and immediate CT followed by delayed CT of the spinal canal at 10 to 12 hr. Every case demonstrated findings suggestive of necrosis and/or cavitation of the central portions of the spinal cord on the delayed CT study. Two types of abnormalities were visualized in the form of delayed collections of contrast media inside the cord: (1) bilateral enhancement, a double-barreled “snake-eyes” appearance at or near the level of compression (consistent with central gray matter necrosis and/or cavitation—local syringomyelia ex-vacuo); and (2) longitudinally oriented, “pencil-shaped” central enhancement of variable length distant from the level of compression (consistent either with an enlarged central canal—hydromyelia exvacuo—or with necrosis and/or cavitation extending craniad and caudad from the area of maximal compression and located in or near the anterior portion of the dorsal columns—distant syringomyelia ex-vacuo). These findings, supported by previous reports of autopsy specimens, may explain in part: (1) the frequent discrepancy between the levels of maximal cervical compression and the variable neurologic signs; and (2) the frequent lack of improvement in clinical signs after surgical decompression of the spinal cord at this late stage of the illness. We believe similar intramedullary lesions may be present in other cases of chronic compression of varying etiology at any location within the spinal cord.
Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Child; Drug Evaluation; Glucocorticoids; Humans; Skin Diseases
PubMed: 70693
DOI: No ID Found -
AJNR. American Journal of Neuroradiology 1986Hydromyelia was discovered in six of 13 patients with diastematomyelia. In one patient, hydromyelia affected only the segments of spinal cord above the diastematomyelia....
Hydromyelia was discovered in six of 13 patients with diastematomyelia. In one patient, hydromyelia affected only the segments of spinal cord above the diastematomyelia. In five patients, hydromyelia extended downward from the single cord into one or both hemicords. Because hydromyelia and diastematomyelia occur simultaneously, because they may produce very similar clinical changes, and because simultaneous or sequential surgical correction of both conditions may be necessary to achieve the best clinical result, the possibility of hydromyelia should be evaluated specifically in each patient demonstrated to have diastematomyelia.
Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Male; Neural Tube Defects; Syringomyelia; Tomography, X-Ray Computed
PubMed: 3085450
DOI: No ID Found -
Cureus Jan 2023The dermal sinus tract (DST) is an infrequent form of spina bifida occulta that can be complicated by infections. This is a case report of a child with a rare...
The dermal sinus tract (DST) is an infrequent form of spina bifida occulta that can be complicated by infections. This is a case report of a child with a rare association of DST complications, namely hydromyelia and intramedullary abscess. A 1-year-old male child was admitted to the hospital with a history of fever and progressive loss of lower-limb movements and the presence of an ostium in the midline of the lumbar region and cutaneous stigmas with no secretion discharge. Computed tomography and magnetic resonance imaging (MRI) of the thoracolumbar spine revealed an extensive intradural T12-S1 abscess and cystic dilatation of the central medullary canal (hydromyelia) from T2 to T12. The surgery was conducted with the drainage of the large abscess and also improving hydromyelia. After 30 days of rehabilitation with physical therapy, the child could walk despite right crural monoparesis (possible L4/L5 injury). This report described a case of DST that showed a rare association of two complications, i.e., intramedullary abscess and hydromyelia, due to a late diagnosis. Sequelae could have been prevented with early diagnosis.
PubMed: 36618502
DOI: 10.7759/cureus.33410 -
The Journal of Veterinary Medical... Dec 2017A Japanese Black calf, manifested by clinical signs of inability to stand and extending hind limbs after birth, was investigated clinically and pathologically. In the...
A Japanese Black calf, manifested by clinical signs of inability to stand and extending hind limbs after birth, was investigated clinically and pathologically. In the neurological inspection, gastrocnemius reflex and patellar tendon reflex of the right hind limb were hyperactive, and gastrocnemius reflex and crossed extension reflex of the left hind limb were also hyperactive. Magnetic resonance imaging (MRI) examination showed a cavity in the cord at the area of the third and fourth lumbar vertebrae in T2-weighted imaging. After the calf was euthanized, necropsy confirmed the swelling of the spinal cord at the third and fourth lumbar vertebrae. The histopathological examination confirmed that the central canal remained open, and the inner surface of central canal was lined with ependymal cells. Therefore, this calf was diagnosed to have hydromyelia of the lumbar cord. This study indicated that MRI was useful for diagnosing myelodysplasia such as hydoromyelia. This is the first report of hydoromyelia in Japanese Black calf.
Topics: Animals; Cattle; Cattle Diseases; Magnetic Resonance Imaging; Spinal Cord; Syringomyelia
PubMed: 29081477
DOI: 10.1292/jvms.17-0371 -
The Canadian Veterinary Journal = La... Dec 1988A one-year-old domestic long-haired cat was referred to the New York State College of Veterinary Medicine because of acute onset of paraparesis and hyperesthesia...
A one-year-old domestic long-haired cat was referred to the New York State College of Veterinary Medicine because of acute onset of paraparesis and hyperesthesia associated with trauma. Myelography and cerebrospinal fluid analysis revealed severe hydromyelia and myelitis, respectively. The definitive diagnosis of feline infectious peritonitis was made by histological examination at necropsy. Lesions were confined exclusively to the brain and spinal cord. Partial occlusion of the third and fourth ventricles with pyogranulomatous debris caused hydrocephalus and subsequent hydromyelia. The hydromyelia may have been the primary means of compensation for the hydrocephalus, thus masking subclinical disease.
PubMed: 17423201
DOI: No ID Found -
The Neurohospitalist Oct 2021Syringomyelia is an uncommon late complication of tuberculous meningitis with a latency period of up to 18 years. Acute hydromyelia is exceedingly rare with few case...
Syringomyelia is an uncommon late complication of tuberculous meningitis with a latency period of up to 18 years. Acute hydromyelia is exceedingly rare with few case reports occuring within the first 6 weeks. We present a case and magnetic resonance imaging of a 38-year-old immunocompetent woman with this rare complication of early hydromyelia due to tuberculous meningitis which responded to ventriculoperitoneal shunting, highlighting that early detection and treatment may improve prognosis.
PubMed: 34567401
DOI: 10.1177/1941874420985989 -
Acta Neurochirurgica Oct 2020Following spinal cord injury (SCI), the routine use of magnetic resonance imaging (MRI) resulted in an incremental diagnosis of posttraumatic syringomyelia (PTS)....
BACKGROUND
Following spinal cord injury (SCI), the routine use of magnetic resonance imaging (MRI) resulted in an incremental diagnosis of posttraumatic syringomyelia (PTS). However, facing four decades of preferred surgical treatment of PTS, no clear consensus on the recommended treatment exists. We review the literature on PTS regarding therapeutic strategies, outcomes, and complications.
METHODS
We performed a systematic bibliographic search on ("spinal cord injuries" [Mesh] AND "syringomyelia" [Mesh]). English language literature published between 1980 and 2020 was gathered, and case reports and articles examining syrinx due to other causes were excluded. The type of study, interval injury to symptoms, severity and level of injury, therapeutic procedure, duration of follow-up, complications, and outcome were recorded.
RESULTS
Forty-three observational studies including 1803 individuals met the eligibility criteria. The time interval from SCI to the diagnosis of PTS varied between 42 and 264 months. Eighty-nine percent of patients were treated surgically (n = 1605) with a complication rate of 26%. Symptoms improved in 43% of patients postoperatively and in 2% treated conservatively. Stable disease was documented in 50% of patients postoperatively and in 88% treated conservatively. The percentage of deterioration was similar (surgery 16%, 0.8% dead; conservative 10%). Detailed analysis of surgical outcome with regard to symptoms revealed that pain, motor, and sensory function could be improved in 43 to 55% of patients while motor function deteriorated in around 25%. The preferred methods of surgery were arachnoid lysis (48%) and syrinx drainage (31%).
CONCLUSION
Even diagnosing PTS early in its evolution with MRI, to date, no satisfactory standard treatment exists, and the present literature review shows similar outcomes, regardless of the treatment modality. Therefore, PTS remains a neurosurgical challenge. Additional research is required using appropriate study designs for improving treatment options.
Topics: Adult; Decompression, Surgical; Drainage; Female; Humans; Male; Middle Aged; Postoperative Complications; Reoperation; Sensation; Spinal Cord Injuries; Syringomyelia
PubMed: 32820376
DOI: 10.1007/s00701-020-04529-w