41. Syringomyelia

Question 1

What is it?

Answer 1

development of a fluid-filled cavity or syrinx (cyst) within the spinal cord.
This cyst can expand and elongate over time, destroying the spinal cord. The damage may result in pain, paralysis, weakness, and stiffness in the back, shoulders, and extremities.

Question 2

sings and symptoms

Answer 2

causes a wide variety of neuropathic symptoms due to damage of the spinal cord and the nerves inside.

Patients may experience
severe chronic pain
abnormal/loss of sensations (particularly in the hands)
If the syrinx is higher up in the spinal cord/affecting the brainstem: vocal cord paralysis, ipsilateral tongue wasting, trigeminal nerve sensory loss may occur.

Question 3

Cause

Answer 3

Congenital:
Arnold–Chiari malformation (the most common cause of syringomyelia, where the anatomic abnormality which may be due to a small posterior fossa causes the lower part of the cerebellum to protrude from its normal location in the back of the head into the cervical or neck portion of the spinal canal.)

Acquired:
Complication of trauma, meningitis, hemorrhage, a tumor, or arachnoiditis.

Question 4

Diagnosis

Answer 4

MRI
CT
EMG
Myelogram

Question 5

Treatment

Answer 5

Surgery
In some patients it may also be necessary to drain the syrinx, which can be accomplished using a catheter, drainage tubes, and valves.