Combined isotope ventriculography and lumbar myelocisternography in the diagnosis of communicating syringomyelia

Peserico, L; Angiari, P; Merli, Giulia; Sonnino, Vittorio; Faglioni, P.; Canossi, Gian Carlo

doi:10.3171/jns.1976.45.5.0576

Journal of Neurosurgery

1976

DOI: 10.3171/jns.1976.45.5.0576

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Combined isotope ventriculography and lumbar myelocisternography in the diagnosis of communicating syringomyelia

L Peserico¹,

P Angiari²,

Giulia Merli³

et al.

Abstract: Several investigative procedures are currently used to diagnose communicating syringomyelia. The combination of isotope ventriculography and lumbar myelocisternography has never proposed nor carried out to verify this condition. We feel that this is a safe and valuable procedure to identify a patent central canal communicating with the fourth ventricle and is worth considering when diagnosing communicating syringomyelia.

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Radiographic studies of the ventricles in syringomyelia

West

Williams

1980

Neuroradiology

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Radiographic investigations of 171 patients with "communicating' syringomyelia have been reviewed. Hydrocephalus was found in one-third of the cases and has occasionally progressed after operation on the posterior fossa, sometimes with accompanying clinical deterioration. The outlets of the fourth ventricle were usually abnormal; tonsillar descent, arachnoiditis and both together were seen. Arachnoiditis correlated strongly with a history of difficult birth. The foramen of Magendie was sometimes patent and sometimes blocked. There was no consistent level of occlusion corresponding to a persistent roof of the fourth ventricle. The cisterna magna was usually small or obliterated but some examples of large cisterns or subarachnoid pouches were found. Radiological demonstration of a communication from the fourth ventricle to the syrinx occurred in only seven patients by positive contrast material and not by air. It is suggested that a sizable communication is rare at the time when patients seek treatment.

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Radiographic studies of the ventricles in syringomyelia

West

Williams

1980

Neuroradiology

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Siringohidromielografia incidental: registro de um caso

Teixeira

Zaclis

Filho

et al. 1982

Arq. Neuro-Psiquiatr.

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O diagnóstico radiológico dos cistos intramedulares tem preocupado os neurologistas desde que essa entidade foi descrita, há 400 anos 26 . Somente nas últimas décadas é que foram introduzidos e padronizados os procedimentos neurorradiológicos para o estudo da siringomielia e da hidromielia; radiografias simples de crânio e de coluna vertebral, perimielografia com contrastes radiopacos, perimielografia gasosa, ventriculografia, tomografia axial por computação e a combinação de todos eles. São raras, entretanto, as publicações sobre a contrastação percutânea da cavidade siringomiélica 3 > 14 > 26 > 40 . O objetivo do presente trabalho é o de apresentar os achados radiológicos de uma siringomielocistografia obtida acidentalmente durante a realização de perimielografia em doente com mielomeningomielocele lombar. OBSERVAÇÃO C.R.S. -Doente com 5 anos de idade, do sexo masculino, atendido na Clínica Neurológica do Hospital das Clínicas da USP, com 5 meses de deficit motor progressivo nos membros inferiores. Apresentava, desde o nascimento, tumor de consistência endurecida na região lombar. Havia história de retardo para inicio de deambulação e ausência de controle esfincteriano fecal e urinário. Ao exame notava-se: paraparesia crural flácida e área de cicatriz de forma circular medindo 4 cm. de diâmetro, com limites irregulares, localizada na transição lombo-sacral. O estudo radiológico simples da coluna vertebral revelou que a 5* vertebra lombar era bifida e que o canal vertebral lombar e cervical apresentava-se moderadamente alargado. Com a finalidade de diagnosticar lesão intrarraqueana que pudesse contribuir para o agravamento progressivo do quadro neurológico, o estudo perimielográfico foi realizado por meio de punção lombar nos interespaços L3-L4. O líquido obtido pela punção era límpido, incolor e normotenso, e 5 cc de Lipiodol ultrafluido foram injetados. A radiografia revelou a presença de lojas superpostas contendo contraste radiopaco, com dimensões variadas, septadas transversalmente, dispostas de modo mais ou menos regular ao longo de toda a medula espinal, e alcançando maior volume na região

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Combined isotope ventriculography and lumbar myelocisternography in the diagnosis of communicating syringomyelia

Cited by 2 publications

References 4 publications

Radiographic studies of the ventricles in syringomyelia

Radiographic studies of the ventricles in syringomyelia

Siringohidromielografia incidental: registro de um caso

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