Syringomyelia Flashcards

1
Q

What is a syrinx?

A

A tubular cavity in or close to the central canal of the cervical cord filled with CSF

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2
Q

In syringomyelia, the cavity may be static for years or may worsen fast - what can cause this?

A

Coughing or sneezing - increased pressure causes extension of the cavity e.g into brainstem (syringobulbia)

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3
Q

When is the mean age of onset?

A

30 years old

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4
Q

What can cause it?

A
Several causes:
Chiari malformation- cerebellum herniates through foremen magnum 
Spinal cord tumours 
Meningitis 
Spinal cord injury
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5
Q

What is the classic presentation?

A

Cape like (neck and arms) loss of sensation to temperature, crude touch and pain but preservation of light touch, proprioception and vibration
- patients burn hand without realising
This is due to the crossing spinothalamic tracts in the anterior commissure of the spinal cord being the first tracts to be affected

Other symptoms and signs: 
Spastic weakness
Paraesthesia 
Neuropathic pain 
Up going plantars
Bowel and bladder dysfunction
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6
Q

What imaging should be done?

A

MRI spine and brain - look for chiari malformation, size of syrinx

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7
Q

What do the symptoms depend on?

A

The location and size of the syrinx

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8
Q

What is syringobulbia?

A

Fluid filled cavity within the medulla of brainstem - often an extension of the Syringomyelia but can be isolated

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9
Q

If the syrinx is not treated, what can happen over a number of years?

A

Scoliosis

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10
Q

How does the syrinx grow?

A

Grows outwards from the central canal

Can also grow longitudinally

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11
Q

Where does the spinothalamic pathway decussate?

A

At the level it enters
Primary neurone synapses in the grey matter of dorsal horn
Secondary neurone crosses over anterior white commissure - where the damage caused by the syrinx is

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12
Q

Are the symptoms seen bilaterally?

A

Yes

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