Aracnoidite constritiva causada por pantopaque resultando em siringomielia e paraparesia: relato de caso

Silva, José Alberto Gonçalves da; Taricco, Mario Augusto; Brito, Jussara; Neves, Valdir Delmiro; Farias, Ronald de Lucena

doi:10.1590/s0004-282x2001000400028

Cited by 4 publications

(1 citation statement)

References 26 publications

(33 reference statements)

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“…3). 7,17 Echols’ procedure appears to have resulted in permanent syrinx resolution, but unfortunately did not prevent progressive thoracic myelopathy.…”

Section: Case Reportmentioning

confidence: 98%

Long-term result of the Echols procedure for treating syringomyelia

Peterson¹,

Crăciun²,

Heiss³

2009

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In 1974, a 9-year-old girl with syringomyelia and scoliosis was treated using the Echols procedure, a surgical technique that makes use of a metal stent to maintain drainage of fluid from the syrinx into the subarachnoid space. The patient presented to the authors' institution 34 years later with a history of progressive myelopathy and surgically treated deformities of the thoracic spine, lumbar spine, and right foot. Computer-assisted myelography indicated that the metal wire remained in place and that the syrinx had collapsed. Neurological examination and neurophysiological testing confirmed the presence of thoracic myelopathy, which may have been due to the wire tethering the thoracic spinal cord to the dorsal dura. This case is believed to be the only long-term report of the effects of the Echols procedure. The history of direct treatment of syringomyelia is reviewed and is contrasted with indirect treatment of syringomyelia, which relieves the condition by opening obstructed CSF pathways within the foramen magnum or spine.

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“…3). 7,17 Echols’ procedure appears to have resulted in permanent syrinx resolution, but unfortunately did not prevent progressive thoracic myelopathy.…”

Section: Case Reportmentioning

confidence: 98%

Long-term result of the Echols procedure for treating syringomyelia

Peterson¹,

Crăciun²,

Heiss³

2009

SPI

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Impacted cisterna magna without syringomyelia associated with spastic paraparesis: case report

Silva¹,

Costa²,

Holanda³

et al. 2006

Arq. Neuro-Psiquiatr.

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-We re p o rton a 49 year old man with impacted cisterna magna without the presence of syringoh y d romyelie (SM). The clinical picture was characterized by spastic paraparesis. Magnetic resonance imaging depicted a cisterna magna filled by the cerebellar tonsils. Six months after osteodural-neural decomp ression of the posterior fossa there was resolution of neurological symptoms and signs with the exception of hyperactive patellar and Achilles reflexes.KEY WORDS: tight cisterna magna, impacted cisterna magna, Chiari malformation, posterior fossa decompression, spastic paraparesis. Relatamos o caso de paciente de 49 anos com cisterna magna impactada sem a pre s e n ç a de siringo-hidromielia (SM). O quadro clínico caracterizava-se por paraparesia espástica. A re s s o n â n c i a magnética evidenciou a cisterna magna preenchida pelas tonsilas cerebelares. Seis meses após a descomp ressão osteodural-neural da fossa posterior, houve resolução dos sintomas e sinais neurológicos, com exceção da hiperatividade dos reflexos patelares e aquileus.PA L AV R A S -C H AVE: cisterna magna impactada, malformação de Chiari, descompressão da fossa posterior, paraparesia espástica.Hans Chiari 1 , 2 described four types of cere b e l l a r anomalies (CM). Type I characterized by downward displacement of the cerebellar tonsils and the medial portions of the inferior cerebellar lobes which accompanied the medulla into the cervical spinal canal. Type II showed downward displacement of port i o n s of the cerebellum (1891), and portions of the inferior vermis (1895), pons, medulla oblonga and, at least, p a rt of lengthened fourth ventricle, which re a c h e d the disc C 4-C 5, into the enlarged cervical spinal canal. In type III, the hydrocephalic cerebellum, pons and medulla oblonga were inside a cervical meningocele (hydroencephaloceles cerebellaris cerv i c a l i s ) , t h rough a spina bifida of the first three cervical vertebrae. In type IV, there was hipoplasia of the cerebellum without herniation of cerebellar stru c t u res into the spinal canal. Iskandar et al. 3 (1998) related five cases of syringohidromyelia (SM), in which the cist e rna magna was filled by the cerebellar tonsils. After d e c o m p ression of the posterior fossa, there was clinical improvement, as well as marked reduction in the size of the syrinx in all cases. The authors admitted t h a t this dramatic response to decompression indicates that this entity has a Chiari-like pathophysiology.

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Syringomyelia caused by intrathecal remnants of oil-based contrast medium

Kubota

Shin

Taniguchi

et al. 2008

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✓ Oily contrast medium had been in use since the early 19th century as a radiographic agent for detecting spinal lesions and spinal cord tumors until the late 20th century. At that point computed tomography scanning and magnetic resonance imaging, or other hydrophilic contrast medium substituted for it. Adverse effects of oil-based dye, both acute and chronic, had been reported since the middle of the 20th century. In this paper the authors report the case of syringomyelia that seemed to be caused mainly by remaining oily contrast medium for 44 years. Syringomyelia secondary to adhesive arachnoiditis caused by oily contrast medium after a long period of time is well known. In the present case, however, surgery revealed only mild arachnoiditis at the level of syringomyelia as well as both solid and liquid remnants of contrast medium. Generally, cerebrospinal fluid (CSF) blockage due to an arachnoid adhesion is considered to cause syringomyelia following adhesive arachnoiditis. The authors speculated that in the present case syringomyelia was induced by a mechanism different from that in the previously reported cases; the oily contrast medium itself seems to have induced the functional block of CSF and impaired the buffer system of the intrathecal pressure. No reports on thoracic adhesive arachnoiditis and syringomyelia caused by oil-based dye referred to this mechanism in reviewing the literature.

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Aracnoidite constritiva causada por pantopaque resultando em siringomielia e paraparesia: relato de caso

Cited by 4 publications

References 26 publications

Long-term result of the Echols procedure for treating syringomyelia

Long-term result of the Echols procedure for treating syringomyelia

Impacted cisterna magna without syringomyelia associated with spastic paraparesis: case report

Syringomyelia caused by intrathecal remnants of oil-based contrast medium

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