Syringomyelia and Lower Urinary Tract Dysfunction
Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg in Essentials of the Adult Neurogenic Bladder, 2020
Syringomyelia is a condition that presents within the spinal cord. While there are many methods of formation, each method results in a fluid-filled cavity known as a “syrinx.” The cavity that forms fills with cerebrospinal fluid and can cause a variety of symptoms. If the syrinx is left untreated, it may continue to grow. Generally, the larger the syrinx is, the more symptomatic a patient will be. Syringomyelia develops over long periods of time and can have very devastating effects on the body. A major problem that can arise in patients with syringomyelia is the development of lower urinary tract disorder. Syringomyelia can be diagnosed using magnetic resonance imaging and can be detected through neurologic, urologic, and clinical signs. The major forms of syringomyelia are split into primary cases with unknown causes and secondary cases with known causes.
Syringomyelia and lower urinary tract dysfunction
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
Syringomyelia manifests as a liquid cavity in the spinal cord. It may be accompanied by neurologic signs. This type of spinal cord cavity has been known for a long time through autopsies and dissections. The name “syringomyelia” was coined by Olivier d’Angers in 1824 (syrinx = flute used by the Greek god Pan), described in 1867 by Bastian and only accepted as a real entity since the years 1950–1960 after Freeman’s studies (1953) and the first report by Barnett and Jousse in 1966. Its evolution is classically slow and can become functionally disabling if untreated. Most syringomyelias occur in a congenital malformative context (primary syringomyelia), with a late clinical expression. A secondary syringomyelia can occur after a spinal cord injury (SCI). The diagnosis is made by magnetic resonance imaging (MRI), but the mechanisms of syringomyelia occurrence are not perfectly understood.
Abnormal gas myelogram
Milosh Perovitch in Radiological Evaluation of the Spinal Cord, 2019
Clinical signs of syringomyelia depend upon the extent of destruction caused to the cells and fibers of the spinal cord. Wasting of the small muscles and the weakness of the hands that appear as an early insidious motor symptom are connected with the lesion of the posterolateral area of the anterior horns of the cervicothoracic spinal cord. The wasting of the muscles may be unilateral or may involve, from the very beginning, both hands with the tendency to spread gradually to the forearms, proximal parts of the upper extremities, and shoulders.60 The weakness and a certain degree of spasticity are linked to the compression of the corticospinal tract. The damage to the spinothalamic fibers will cause the characteristic dissociated anesthesia (dissociated sensory loss of Charcot), and the destruction of the intermediolateral tract in the upper thoracic region accounts for the appearance of the autonomic symptoms.60 Trophic changes, particularly of the upper extremities, and symptoms of corticospinal tract degeneration in the lower limbs, will become apparent, thus completing the principle clinical features of syringomyelia.60
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
Syringomyelia is a condition caused by a fluid-filled cyst in the spinal cord [6,7]. It also can be caused by intramedullary lesions and idiopathic, congenital, or traumatic accidents. Syringomyelia is not a rare condition and is commonly seen in patients with CM1. The most common cause of syringomyelia is CM1 [7–9]. However, the exact relationship between CM1 and associated syringomyelia is not known. In CM1, the herniated cerebellar tonsils below the foramen magnum can reduce the cerebrospinal fluid (CSF) flow. Thus, the CSF flow in the brain and spinal canal has been affected, potentially leading to the accumulation of CSF in the subarachnoid space (SS) of the brain and spine. CM1 may increase intracranial pressure on the brain, resulting in hydrocephalus. Moreover, CM1 may increase the pressure on the medulla spinalis tissues and cause CSF to accumulate in the central channel [3,8,9].
Syringosubarachnoid shunt: insertion technique
Published in British Journal of Neurosurgery, 2023
Meriem Amarouche, Viviana Minichini, Heather Davis, Anastasios Giamouriadis, Sanjeev Bassi
Syringomyelia is an abnormal fluid filled cavity which causes distortion of the spinal cord rendering it thinner and often causing it to bulge through the dural opening. During the approach to the syrinx through the myelotomy the dorsal columns need to be preserved in order to reduce the risk of consequent neurological deficit. On the other hand, whilst inserting the subarachnoid end of a shunt, the main anatomic landmark that needs to be identified is the dentate ligament because it can prevent adequate insertion and drainage of the shunt. These ligaments are important structures located in the pia matter on each side of the spinal cord. They are believed to provide stability to the spinal cord within the spinal canal by attaching the pia to the arachnoid and dura matters.1
The influence of concomitant syringomyelia on patient reported outcome following hind brain decompression
Published in British Journal of Neurosurgery, 2020
Petr Janous, Tim Pigott, Neil Buxton, Andrew Brodbelt
Descent of the cerebellar tonsils was first described as a pathological condition in 1891 by Hans Chiari.1 A Chiari 1 malformation is defined radiologically as tonsillar herniation of at least 5 mm bellow the foramen magnum.2 30–75% of patients with a Chiari malformation will develop syringomyelia.2–4 Patients with a Chiari malformation may be split into asymptomatic and symptomatic groups.5 The asymptomatic group represent either patients with incidental findings of Chiari malformation or patients with vague symptoms which are difficult to attribute to this condition.5 The symptomatic patients most commonly present with headache related to coughing or sneezing, neck pain, double vision, nausea, dysphagia, lethargy, or symptoms related to syrinx formation often in the second to third decade of life.5,6 Patients with syringomyelia may develop limb pain, weakness, or paraesthesia.3,7,8
Related Knowledge Centers
- Cyst
- Paresthesia
- Sympathetic Nervous System
- Paralysis
- Spinal Cord
- Parasympathetic Nervous System
- Paresis
- Syrinx
- Myelopathy
- Vocal Cord Paresis