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The Journal of Veterinary Medical... Dec 2001A 3-month-old male Japanese cat with feline parvovirus infection, showing central and cervical nerve abnormalities, was diagnosed as hydrocephalus and syringomyelia by...
A 3-month-old male Japanese cat with feline parvovirus infection, showing central and cervical nerve abnormalities, was diagnosed as hydrocephalus and syringomyelia by use of magnetic resonance imaging (MRI). The cat was maintained clinically by medical treatment even though he could not stand. The MRI scans obtained about 5 months later showed that the ventricles had increased in size and the cervical syrinx had extended into the thoracic spinal cord. Ventriculoperitoneal (VP) shunt was performed. One week after surgery, neurological conditions had improved. At the postoperative MR images, the ventricles had decreased in size and the syrinx in the cervical and thoracic spinal cord could no longer be seen. The cat was still alive and was able to walk well.
Topics: Animals; Cat Diseases; Cats; Diuretics; Furosemide; Hydrocephalus; Magnetic Resonance Imaging; Male; Syringomyelia; Ventriculoperitoneal Shunt
PubMed: 11789613
DOI: 10.1292/jvms.63.1331 -
Proceedings of the Royal Society of... Jul 1969
Topics: Adult; Foramen Magnum; Humans; Male; Radiography; Skull; Spine; Syringomyelia
PubMed: 5803527
DOI: No ID Found -
International Journal of Medical... 2011It is very rare that a foramen magnum arachnoid cyst induces compression of the spinal cord and syringomyelia, and currently there are few treatment experiences... (Review)
Review
It is very rare that a foramen magnum arachnoid cyst induces compression of the spinal cord and syringomyelia, and currently there are few treatment experiences available. Here we reported the case of a 43-year-old male patient who admitted to the hospital due to weakness and numbness of all 4 limbs, with difficulty in urination and bowel movement. MRI revealed a foramen magnum arachnoid cyst with associated syringomyelia. Posterior fossa decompression and arachnoid cyst excision were performed. Decompression was fully undertaken during surgery; however, only the posterior wall of the arachnoid cyst was excised, because it was almost impossible to remove the whole arachnoid cyst due to toughness of the cyst and tight adhesion to the spinal cord. Three months after the surgery, MRI showed a reduction in the size of the arachnoid cyst but syrinx still remained. Despite this, the symptoms of the patient were obviously improved compared to before surgery. Thus, for the treatment of foramen magnum arachnoid cyst with compression of the spinal cord and syringomyelia, if the arachnoid cyst could not be completely excised, excision should be performed as much as possible with complete decompression of the posterior fossa, which could result in a satisfying outcome.
Topics: Adult; Arachnoid Cysts; Decompression, Surgical; Foramen Magnum; Humans; Magnetic Resonance Imaging; Male; Spinal Cord; Spinal Cord Compression; Syringomyelia; Treatment Outcome
PubMed: 21647327
DOI: 10.7150/ijms.8.345 -
AJNR. American Journal of Neuroradiology 1987Four normal controls and 26 cases of Arnold-Chiari I malformations and/or syringomyelia were reviewed. The pathologic cases included five isolated Arnold-Chiari I... (Comparative Study)
Comparative Study
Four normal controls and 26 cases of Arnold-Chiari I malformations and/or syringomyelia were reviewed. The pathologic cases included five isolated Arnold-Chiari I malformations, nine communicating syringomyelia, five idiopathic syringomyelia, four posttraumatic syringomyelia, one syringomyelia with hemangioblastoma, and two postshunt syringomyelia. The objectives of this study were to compare the accuracy of conventional metrizamide myelography with CT metrizamide myelography and to study indirectly the hydrodynamics of CSF flow in syringomyelia by comparing the sequential enhancement patterns of the spinal cords and cord cavities in the different groups of patients. Twenty-five patients underwent conventional metrizamide myelography immediately before CT metrizamide myelography, and one patient underwent CT metrizamide myelography only. Scans were obtained 1-2 hr, 4-8 hr, and 12-24 hr after injection of metrizamide, but not all patients were scanned during all three intervals. CT metrizamide myelography was found to be more sensitive than conventional metrizamide myelography in the diagnosis of both Arnold-Chiari I malformation and syringomyelia. Performing just an immediate and a delayed scan was found to be more cost-effective than doing all three scans. Contrary to previous reports, it was found that delayed (12-24 hr) scans demonstrated more syrinx cavities than intermediate ones. In studying the sequential enhancement patterns of the spinal cords and cord cavities, some interesting trends were observed that tend to support the theories of Aboulker and of Ball and Dayan of transneural passage of CSF into cord cavities in syringomyelia.
Topics: Adult; Aged; Arnold-Chiari Malformation; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Radiographic Image Enhancement; Spinal Cord; Syringomyelia; Time Factors; Tomography, X-Ray Computed
PubMed: 3101451
DOI: No ID Found -
Turkish Neurosurgery 2016To analyze retrospectively the surgical management of reducible atlantoaxial dislocation (AAD), basilar invagination (BI) and Chiari malformation (CHM) with...
AIM
To analyze retrospectively the surgical management of reducible atlantoaxial dislocation (AAD), basilar invagination (BI) and Chiari malformation (CHM) with syringomyelia through a single-stage posterior approach.
MATERIAL AND METHODS
Forty-three patients with reducible AAD, BI and CHM with syringomyelia underwent surgery from January 2009 to January 2013. Intraoperative restoration followed by posterior decompression and plate-rod placement with occipital cortical screws and C2/C3 lateral mass cortical screws fixation devices were used in all patients. Results were recorded both pre- and postoperatively and these outcome measures included Nurick grading (NG) and radiology findings (atlantodental interval (ADI), space available for the spinal cord (SAC), interval between odontoid and Chamberlain's line (IOC), and the cervicomedullary angle (CMA)).
RESULTS
Forty (93%) of the 43 patients were followed up. Thirty-six (90%) patients' symptoms improved and four (10%) stabilized. No patients became progressively worse. The difference between preoperative and postoperative Nurick grades was statistically significant. All patients achieved restoration, including thirty (75%) patients had full restoration and ten (25%) had part restoration. The size of syringomyelia was obviously decreased in 32 (80%) patients and stable in 8 (20%) patients. All radiology findings (ADI, IOC, SAC, CMA) showed significant changes from pre- to postoperative (p < 0.01).
CONCLUSION
Intraoperative distraction, extension combined posterior decompression with use of plate-rod-screws occipitocervical fusion device is an effective method to treat AAD, BI and CHM with syringomyelia.
Topics: Adult; Arnold-Chiari Malformation; Atlanto-Axial Joint; Bone Plates; Cervical Vertebrae; Decompression, Surgical; Disease Management; Female; Humans; Joint Dislocations; Male; Middle Aged; Neck Injuries; Prostheses and Implants; Retrospective Studies; Spinal Fusion; Syringomyelia; Young Adult
PubMed: 27400111
DOI: 10.5137/1019-5149.JTN.13884-14.2 -
Journal of Neurosurgery. Spine Dec 2010Craniocervical decompression for Chiari malformation Type I (CM-I) and syringomyelia has been reported to fail in 10%-40% of patients. The present prospective clinical...
OBJECT
Craniocervical decompression for Chiari malformation Type I (CM-I) and syringomyelia has been reported to fail in 10%-40% of patients. The present prospective clinical study was designed to test the hypothesis that in cases in which syringomyelia persists after surgery, craniocervical decompression relieves neither the physiological block at the foramen magnum nor the mechanism of syringomyelia progression.
METHODS
The authors prospectively evaluated and treated 16 patients with CM-I who had persistent syringomyelia despite previous craniocervical decompression. Testing before surgery included the following: 1) clinical examination; 2) evaluation of the anatomy using T1-weighted MR imaging; 3) assessment of the syrinx and CSF velocity and flow using cine phase-contrast MR imaging; and 4) appraisal of the lumbar and cervical subarachnoid pressures at rest, during a Valsalva maneuver, during jugular compression, and following the removal of CSF (CSF compliance measurement). During surgery, ultrasonography was performed to observe the motion of the cerebellar tonsils and syrinx walls; pressure measurements were obtained from the intracranial and lumbar intrathecal spaces. The surgical procedure involved enlarging the previous craniectomy and performing an expansile duraplasty with autologous pericranium. Three to 6 months after surgery, clinical examination, MR imaging, and CSF pressure recordings were repeated. Clinical examination and MR imaging studies were then repeated annually.
RESULTS
Before reexploration, patients had a decreased size of the CSF pathways and a partial blockage in CSF transmission at the foramen magnum. Cervical subarachnoid pressure and pulse pressure were abnormally elevated. During surgery, ultrasonographic imaging demonstrated active pulsation of the cerebellar tonsils, with the tonsils descending during cardiac systole and concomitant narrowing of the upper pole of the syrinx. Three months after reoperation, patency of the CSF pathways was restored and pressure transmission was improved. The flow of syrinx fluid and the diameter of the syrinx decreased after surgery in 15 of 16 patients.
CONCLUSIONS
Persistent blockage of the CSF pathways at the foramen magnum resulted in increased pulsation of the cerebellar tonsils, which acted on a partially enclosed cervical subarachnoid space to create elevated cervical CSF pressure waves, which in turn affected the external surface of the spinal cord to force CSF into the spinal cord through the Virchow-Robin spaces and to propel the syrinx fluid caudally, leading to syrinx progression. A surgical procedure that reestablished the CSF pathways at the foramen magnum reversed this pathophysiological mechanism and resolved syringomyelia. Elucidating the pathophysiology of persistent syringomyelia has implications for its primary and secondary treatment.
Topics: Adolescent; Adult; Arnold-Chiari Malformation; Cerebrospinal Fluid Pressure; Child; Decompressive Craniectomy; Disease Progression; Female; Foramen Magnum; Humans; Laminectomy; Magnetic Resonance Imaging; Male; Middle Aged; Prospective Studies; Radiography; Subarachnoid Space; Syringomyelia; Treatment Failure
PubMed: 21121751
DOI: 10.3171/2010.6.SPINE10200 -
Journal of the Royal Society of Medicine Nov 1980
Review
Topics: Animals; Body Fluids; Brain; Brain Diseases; Cerebrospinal Fluid; Humans; Pressure; Syringomyelia
PubMed: 7017117
DOI: 10.1177/014107688007301109 -
Journal of the Royal Society of Medicine Jan 1988
Topics: Humans; Male; Middle Aged; Respiratory Paralysis; Syringomyelia
PubMed: 3343678
DOI: 10.1177/014107688808100136 -
Neurology Mar 2004In some adult patients with cervical syringomyelia, MRI studies do not identify primary disease within the foramen magnum or spinal canal. To identify the etiology of...
In some adult patients with cervical syringomyelia, MRI studies do not identify primary disease within the foramen magnum or spinal canal. To identify the etiology of this idiopathic type of syringomyelia, clinical features and posterior fossa (PF) measurements from 17 of these patients, 17 patients with Chiari I-type syringomyelia, and 32 control subjects were compared. Idiopathic syringomyelia and Chiari I-type syringomyelia manifested central cervical myelopathy and a small PF with narrow CSF spaces, suggesting that they develop by the same mechanism.
Topics: Adult; Cranial Fossa, Posterior; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Syringomyelia
PubMed: 15007134
DOI: 10.1212/01.wnl.0000113746.47997.ce -
AJNR. American Journal of Neuroradiology Sep 2017The development of syringomyelia has been associated with changes in CSF flow dynamics in the spinal subarachnoid space. However, differences in CSF flow velocity...
BACKGROUND AND PURPOSE
The development of syringomyelia has been associated with changes in CSF flow dynamics in the spinal subarachnoid space. However, differences in CSF flow velocity between patients with posttraumatic syringomyelia and healthy participants remains unclear. The aim of this work was to define differences in CSF flow above and below a syrinx in participants with posttraumatic syringomyelia and compare the CSF flow with that in healthy controls.
MATERIALS AND METHODS
Six participants with posttraumatic syringomyelia were recruited for this study. Phase-contrast MR imaging was used to measure CSF flow velocity at the base of the skull and above and below the syrinx. Velocity magnitudes and temporal features of the CSF velocity profile were compared with those in healthy controls.
RESULTS
CSF flow velocity in the spinal subarachnoid space of participants with syringomyelia was similar at different locations despite differences in syrinx size and locations. Peak cranial and caudal velocities above and below the syrinx were not significantly different (peak cranial velocity, = .9; peak caudal velocity, = 1.0), but the peak velocities were significantly lower ( < .001, = .007) in the participants with syringomyelia compared with matched controls. Most notably, the duration of caudal flow was significantly shorter ( = .003) in the participants with syringomyelia.
CONCLUSIONS
CSF flow within the posttraumatic syringomyelia group was relatively uniform along the spinal canal, but there are differences in the timing of CSF flow compared with that in matched healthy controls. This finding supports the hypothesis that syrinx development may be associated with temporal changes in spinal CSF flow.
Topics: Adult; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Spinal Cord Injuries; Syringomyelia
PubMed: 28729294
DOI: 10.3174/ajnr.A5304