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syrinx development

Valentina Baro, Renzo Manara, Luca Denaro, Domenico d'Avella
PURPOSE: Dandy-Walker malformation is a rare condition due to imperforation of the Blake's pouch during intrauterine brain development, usually leading to early severe hydrocephalus. The association with holocord syringomyelia is rare, and from the Gardner's first report in 1957, only 23 cases have been described, mostly from autopsy series and pre-MRI period. Besides a worsening of clinical picture, its occurrence generates some concern about the best surgical treatment that varies widely among the literature reports...
March 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Srdjan Cirovic, Robert Lloyd, Jelena Jovanovik, Holger A Volk, Clare Rusbridge
BACKGROUND: Syringomyelia is a pathological condition in which fluid-filled cavities (syringes) form and expand in the spinal cord. Syringomyelia is often linked with obstruction of the craniocervical junction and a Chiari malformation, which is similar in both humans and animals. Some brachycephalic toy breed dogs such as Cavalier King Charles Spaniels (CKCS) are particularly predisposed. The exact mechanism of the formation of syringomyelia is undetermined and consequently with the lack of clinical explanation, engineers and mathematicians have resorted to computer models to identify possible physical mechanisms that can lead to syringes...
March 9, 2018: BMC Veterinary Research
Ziev B Moses, Gabriel N Friedman, David L Penn, Isaac H Solomon, John H Chi
OBJECTIVE Optimal diagnosis and management strategies for intradural spinal arachnoid cysts (SACs) are still unresolved given the rare nature of this entity, with few large case series and virtually no statistical analyses of patient characteristics in the literature. Here, the authors studied a large patient cohort with these lesions to determine whether pre- or postoperative attributes could be used to aid in either diagnosis or prognosis. METHODS A chart review was completed at a single institution for the period from 2002 to 2016 to determine the preoperative characteristics and postoperative outcomes of 21 patients with exclusively intradural SACs...
February 9, 2018: Journal of Neurosurgery. Spine
Robert A Lloyd, David F Fletcher, Elizabeth C Clarke, Lynne E Bilston
Syringomyelia is associated with Chiari I malformation, although the mechanistic link is unclear. Studies have suggested that cerebrospinal fluid enters the spinal cord via the perivascular spaces, and that changes in the timing of the subarachnoid pressures may increase flow into the spinal cord. This study aims to determine how Chiari malformation and syringomyelia alter the subarachnoid space pressures and hence perivascular flow. Subject-specific models of healthy controls (N = 9), Chiari patients with (N = 7) and without (N = 8) syringomyelia, were developed from magnetic resonance imaging (MRI), to simulate the subarachnoid pressures...
October 25, 2017: Journal of Biomechanics
Idris Amin, Gavriil Ilizarov, Nayeema Chowdhury, Shailaja Kalva
INTRODUCTION: Syringomyelia is a disorder in which a cyst, or syrinx, develops within the spinal cord. Historically, syringomyelia in post-traumatic spinal cord injury has been uncommon; however, its diagnosis has been increasing due to the advances in medical technology. Syringomyelia that involves the entire spinal cord, or holocord, is rare after traumatic spinal cord injury, with only a few cases reported in the literature. CASE PRESENTATION: We present a case of a 57-year-old male who had a motorcycle accident 30 years ago resulting in a spinal cord injury, who presented a rapid decline in the function of his left upper extremity...
2017: Spinal Cord Series and Cases
J Yeo, S Cheng, S Hemley, B B Lee, M Stoodley, L Bilston
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...
July 20, 2017: AJNR. American Journal of Neuroradiology
Monish M Maharaj, Kevin Phan, Ralph Mobbs
Syringomyelia defines a condition in which myelopathy develops secondary to the formation of a cyst or cavity within the spinal cord parenchyma known as a syrinx. Although there is a significant volume of studies analysing the underlying mechanisms behind their formation, the management of such cavities remains an ongoing topic of debate. Aside from conservative approach, a range of surgical options exist, however long term outcomes are poor and a literature search reveals that the overall benefits are questionable...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
K A Gad, D M Yousem
BACKGROUND AND PURPOSE: The association of syringohydromyelia with Chiari I malformation has a wide range, between 23% and 80% of cases in the current literature. In our experience, this range might be overestimated compared with our observations in clinical practice. Because there is an impact of Chiari I malformation-associated syringohydromyelia on morbidity and surgical intervention, its diagnosis is critical in this patient population. Identifying related variables on the basis of imaging would also help identify those patients at risk of syrinx formation during their course of disease...
September 2017: AJNR. American Journal of Neuroradiology
Sathya Vadivelu, Sudhakar Vadivelu, Maureen Mealy, Smurti Patel, Libby Kosnik-Infinger, Daniel Becker
PURPOSE: Transverse myelitis (TM) is an acute inflammatory spinal cord injury. Asymptomatic Chiari I malformation (CMI) management is highly controversial, particularly when associated with a spinal syrinx. Here, we assess the occurrence of CMI in the pediatric TM population and management outcomes. METHODS: We performed a retrospective cohort study based on 61 consecutively identified pediatric TM cases over an -8-year period. We reviewed demographic characteristics, radiographic findings, presenting symptoms, and long-term outcomes...
May 24, 2017: Developmental Neurorehabilitation
Giuseppe Canova, Alessandro Boaro, Enrico Giordan, Pierluigi Longatti
Posttubercular adhesive arachnoiditis is a rare, late complication of tubercular meningitis. Syringomyelia can develop as a consequence of intramedullary cystic lesions and cerebrospinal fluid (CSF) flow disturbance around the spinal cord, even after successful chemotherapy. We reviewed the literature related to posttubercular syringomyelia treatment and suggest a new combined surgical approach. A 25-year-old Nigerian male patient presented with legs numbness, urinary disturbance, and legs weakness. Spinal magnetic resonance revealed a T5-T7 syringomyelia, secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis...
April 2017: Journal of Neurological Surgery Reports
Siri Sahib S Khalsa, Alan Siu, Tiffani A DeFreitas, Justin M Cappuzzo, John S Myseros, Suresh N Magge, Chima O Oluigbo, Robert F Keating
OBJECTIVE Previous studies have indicated an association of Chiari malformation Type I (CM-I) and a small posterior fossa. Most of these studies have been limited by 2D quantitative methods, and more recent studies utilizing 3D methodologies are time-intensive with manual segmentation. The authors sought to develop a more automated tool to calculate the 3D posterior fossa volume, and correlate its changes after decompression with surgical outcomes. METHODS A semiautomated segmentation program was developed, and used to compare the pre- and postoperative volumes of the posterior cranial fossa (PCF) and the CSF spaces (cisterna magna, prepontine cistern, and fourth ventricle) in a cohort of pediatric patients with CM-I...
May 2017: Journal of Neurosurgery. Pediatrics
Ji Yeoun Lee, Shin Won Kim, Saet Pyoul Kim, Hyeonjin Kim, Jung-Eun Cheon, Seung-Ki Kim, Sun Ha Paek, Dachling Pang, Kyu-Chang Wang
OBJECTIVE There has been no established animal model of syringomyelia associated with lumbosacral spinal lipoma. The research on the pathophysiology of syringomyelia has been focused on Chiari malformation, trauma, and inflammation. To understand the pathophysiology of syringomyelia associated with occult spinal dysraphism, a novel animal model of syringomyelia induced by chronic mechanical compression of the lumbar spinal cord was created. METHODS The model was made by epidural injection of highly concentrated paste-like kaolin solution through windows created by partial laminectomy of L-1 and L-5 vertebrae...
October 2017: Journal of Neurosurgery. Spine
Abhidha Shah, Prashant Sathe, Manoj Patil, Atul Goel
OBJECTIVE: The authors evaluate the significance of atlantoaxial instability in the management of idiopathic syringomyelia. BACKGROUND: We recently observed that atlantoaxial dislocation can be present even when the atlantodental interval was within normal range. Atlantoaxial instability can be identified on the basis of facetal mal-alignment or even by direct observation of status of joint during surgery. Our observations are discussed in nine patients where we identified and treated atlantoaxial instability in cases that would otherwise be considered as having "idiopathic" syrinx...
January 2017: Journal of Craniovertebral Junction and Spine
S Swaroop Chandra, J K Giriraj Harshavardhan, Ganesan G Ram, P V Vijayaraghavan
INTRODUCTION: Neurological complications due to spinal anesthesia are dysesthesia, paresthesia, cauda equina syndrome, and neuropathic joint. However, neurological complications are rare. We report a case of neuropathic joint of knee as a complication of syrinx following postspinal anesthesia. CASE REPORT: A 33-year-old female came with complaints of pain and instability of her left knee and left foot drop. She had developed weakness of her left lower limb following her cesarean section surgery done under spinal anesthesia...
September 2016: Journal of Orthopaedic Case Reports
Elizabeth C Clarke, David F Fletcher, Lynne E Bilston
Syringomyelia (a spinal cord cyst) usually develops as a result of conditions that cause cerebrospinal fluid (CSF) obstruction. The mechanism of syrinx formation and enlargement remains unclear, though previous studies suggest that the fluid enters via the perivascular spaces (PVS) of the penetrating arteries of the spinal cord, and that alterations in the CSF pulse timing and pressure could contribute to enhanced PVS inflow. This study uses an idealised computational model of the PVS to investigate the factors that influence peri-arterial fluid flow...
April 2017: Computer Methods in Biomechanics and Biomedical Engineering
Kristiina Kyrklund, Mikko P Pakarinen, Seppo Taskinen, Reetta Kivisaari, Risto J Rintala
OBJECTIVE The goal of this study was to determine the significance of spinal cord anomalies (SCAs) in patients with anorectal malformations (ARMs) by comparing the outcomes for bowel function, lower urinary tract symptoms (LUTS), and lower-limb neurological abnormalities to these outcomes in patients with similar ARMs and a normal spinal cord. METHODS The spinal cord MRI records of female patients treated for vestibular and perineal fistula (VF/PF) and male patients with rectourethral fistula (RUF) at a single center between 1983 and 2006 were reviewed...
December 2016: Journal of Neurosurgery. Spine
Tatsuya Yasuda, Tomohiko Hasegawa, Yu Yamato, Sho Kobayashi, Daisuke Togawa, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yukihiro Matsuyama
STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the relationship between tumor location and clinical characteristics. OVERVIEW OF LITERATURE: Hemangioblastoma is a rare disease that develops in the central nervous system. Magnetic resonance imaging (MRI) is useful to evaluate hemangioblastomas. Hemangioblastoma's location is designated as intramedullary, intramedullary+extramedullary, or extramedullary by MRI. METHODS: We analyzed 11 patients who underwent surgery for spinal hemangioblastoma...
April 2016: Asian Spine Journal
Albert Tu, Alexander R Hengel, D Douglas Cochrane
OBJECTIVE Although patients with lumbosacral lipomas may be asymptomatic at presentation, most develop neurological symptoms over time. Given the challenges in examining infants, the authors sought to determine whether MRI would be helpful in identifying patients who are more likely to deteriorate early in life and who would potentially benefit from early surgical intervention. METHODS A retrospective review of all patients with lumbosacral lipomas who were seen at the authors' institution between 1997 and 2013 and who were managed without prophylactic surgery was performed...
August 2016: Journal of Neurosurgery. Pediatrics
Devorah Segal, Robert F Heary, Sanjeev Sabharwal, Maureen T Barry, Xue Ming
The authors present the case of a child with megalencephaly-capillary malformation syndrome who developed a rapidly progressive holocord syringomyelia that was treated surgically. A 3-year-old boy with megalencephaly-capillary malformation-polymicrogyria (MCAP) syndrome presented with several months of right leg weakness, worsening scoliosis, and increased seizures. An MRI study of the brain demonstrated a Chiari I malformation and massively dilated syringomyelia extending from C-2 to the conus medullaris. The patient underwent an urgent suboccipital craniectomy with C1-3 laminectomies to relieve the CSF outflow obstruction with significant clinical improvement...
July 2016: Journal of Neurosurgery. Pediatrics
Johnny H Y Wong, Xin Song, Sarah J Hemley, Lynne E Bilston, Shaokoon Cheng, Marcus A Stoodley
OBJECTIVE The pathogenesis of posttraumatic syringomyelia remains enigmatic and is not adequately explained by current theories. Experimental investigations require a reproducible animal model that replicates the human condition. Current animal models are imperfect because of their low reliability, severe neurological deficits, or dissimilar mechanism of injury. The objective of this study was to develop a reproducible rodent model of posttraumatic syringomyelia using a spinal cord impactor that produces an injury that more closely mimics the human condition and does not produce severe neurological deficits...
May 2016: Journal of Neurosurgery. Spine
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