Syringomyelia
SYRINGOMYELIA
• Syringomyelia is the acquired
development of a cavity (syrinx) within
the central spinal cord.
• The lower cervical segments are usually
affected, but extension may occur
upwards into the brain stem
(syringobulbia,) or downwards as far as
the filum terminale.
• Many cases are associated with Chiari
malformations
Causes
• Congenital development (or idiopathic)
• Associated with tumours
(intrarnedullary)
• Post-traumatic
• Arachnoiditis
Clinical Features of Idiopathic
Type
• Disorder is chronic.
• Common in females.
• Age of onset is third to fourth decade
of life.
• Numbness in upper limbs with frequent
bums and injuries that are painless.
• Later, spastic weakness in lower limbs
with urinary bladder involvement occurs.
Signs
• LMN signs in upper limbs, usually at C8T 1 myotomes with wasting of muscles.
• Pyramidal signs in lower limbs.
• spinothalarnic tract involvement
• Sensory disturbance may extend to
neck and face.
• Thoracic kyphoscoliosis is common.
Investigations
• Plain radiograph of cervical spine
• Myelograrn may show widening of spinal
cord
• CT scan and MRI
Treatment
• Surgical removal of obstruction of CSF
flow, if any, along with syringosubarachnoid shunt.
• decompression
• Syringostomy
• syringoperitoneal shunt