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Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
A syringomyelia is a fluid-filled cavity within the spinal cord tissue. Syringobulbia is a fluid-filled cavity within the brainstem. A dilation of the central spinal canal alone is termed hydromyelia.
The nervous system and the eye
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
James A.R. Nicoll, William Stewart, Fiona Roberts
Syringomyelia is a cyst-like space (syrinx) that develops within the cervical cord (syringomyelia) or lower brain stem (syringobulbia). The cavity usually extends through several segments of the cervical cord and, as it enlarges, the cord becomes swollen and soft. Occasionally, syringomyelia occurs in association with tumours affecting the spinal cord. The effects are due to destruction of the cord by the enlarging cavity. The first fibres to be affected are the decussating sensory fibres conveying the sensations of heat and pain: the resulting defect, known as dissociated anaesthesia, is a selective insensitivity to heat and pain in the region corresponding to the involved segments of the spinal cord. A neuropathic arthritis affecting the joints of the upper limbs often occurs.
Neurology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Fenella Kirkham, Adnan Manzur, Stephanie Robb
Examine sensation in the face: pain and temperature are distributed concentrically from around the mouth.tactile sensation is distributed in the V1,V2 and V3 distributions: – any abnormality in brainstem tumour.– dissociated in syringobulbia.
Long-term surgical outcome of Chiari type-I malformation-related syringomyelia: an experience of tertiary referral hospital
Published in Neurological Research, 2022
Anas Abdallah, İrfan Çınar, Betül Güler Abdallah
During the study period, 54 patients with CRS were surgically treated with the PFDD and tonsillar coagulation. Among them, 46 (24 males and 22 females) patients met the study criteria. The mean age was 35.4 ± 9.8 (range; 16–53). Four patients were ≤18 years old (16–18) and were included in the study due to their comparable body mass indices with adults. Headaches were the most commonly seen presenting symptoms that were observed in 24 (52.2%) patients. Table 1 shows the baseline demographic and clinical characteristics of the patients. Impaired cerebellar function tests, such as gait ataxia, nystagmus, dysmetria, and dysdiadochokinesia, were the most common neurological findings in the 32 (69.6%) patients examined. Table 2 summarizes the clinical findings from the first presentation. Tonsillar herniation in 27 (58.7%) patients was <10 mm. The syrinx cavities were in the cervical and cervicothoracic regions in 24 (52.2%) and 18 (39.1%) patients, respectively. The mean preoperative axial S/C was 0.59 ± 0.12 (0.31–0.92). S/C < 0.59 was observed in 20 (43.5%) patients. On cranial CT, 10 (21.7%) patients presented with radiological hydrocephalus (Evans index > 0.30). Septation in syrinx was seen in 17 (37.0%) patients. Syringobulbia was seen in 4 (8.7%) patients. In our patients, craniocervical anomalies, such as basilar impression (n = 5), platybasia (n = 3), atlantoaxial subluxation (n = 3), and Klippel Feil (n = 2), were observed in seven (15.2%) patients. Scoliosis and kyphosis were recorded in 6 (13.0%) and 4 (8.7%), respectively.
Rapid progression of acute cervical syringomyelia: A case report of delayed complications following spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2022
Chenghua Yuan, Jian Guan, Fengzeng Jian
The incidence of post-traumatic syringomyelia varies between 0.3–3.2% and a varying interval between an SCI and the initial presentation of syringomyelia from months to years has been reported,6 but there are limited reports of delayed post-traumatic syringobulbia.7,8 Briefly, a patient with syringobulbia was reported,8 in whom symptomatic regression and a significant reduction in syrinx size occurred after a syringo-peritoneal shunt surgery. Fourteen years before admission, the patient underwent spinal instrumentation surgery for thoracolumbar fractures. A similar case was described involving a T12 compression fracture 30 years prior to the development of new symptoms, with weakness and sensory impairment in the patient’s left arm for 5 years.9 MRI results revealed a syringobulbia. During surgery, the thickened arachnoid membrane was cut, and the foramen of Magendie was explored. Post-operatively, symptoms abated and the syrinx diminished. Unfortunately, the patient's symptoms gradually worsened; it is not clear why the surgery did not target the level of fracture.
Acute deterioration of adults with Chiari I malformation associated with extensive syrinx
Published in British Journal of Neurosurgery, 2020
Fawaz S. Almotairi, Magnus Tisell
We compared the degree of rostral extension of syrinx in relation to vertebral level between patients who presented with acute deterioration and non-acute cases, and we found that extension of syrinx at or above the C1 occurred in all three acute cases and no others. The MRI finding of syringobulbia was seen in two of the patients with CMI who presented with acute deterioration in the present study (3%) of a total of 65 patients who were included, and in both cases it extended to the medulla oblongata. Syringobulbia is rare but is strongly associated with syringomyelia in 1–10.7% of cases and most commonly involves the medulla.30,31 Tubbs et al. did not identify any morphometrical characteristics that are particular to patients with CMI and syringobulbia, as compared to other CMI patients, and it is currently difficult to predict its development in CMI patients.32