Defining the line between hydromyelia and syringomyelia. A differentiation is possible based on electrophysiological and magnetic resonance imaging studies

Röser, Florian; Ebner, Florian; Sixt, C.; Hagen, Jennifer Müller vom; Tatagiba, Marcos

doi:10.1007/s00701-009-0427-x

Cited by 46 publications

(30 citation statements)

References 26 publications

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“…In the literature, there is no uniformity regarding this opinion. For example, Roser et al 34 differentiated hydromyelia as referring simply to a dilated central canal due to IS. These authors portended that IS is accompanied by different clinical and radiological signs.…”

Section: Holly and Batzdorfmentioning

confidence: 99%

“…These authors portended that IS is accompanied by different clinical and radiological signs. According to Roser et al, 34 patients with hydromyelia have no neurological deficits and mainly present with pain that could be radicular, burning, or musculoskeletal. This constellation of symptoms is similar to those described by Holly and Batzdorf.…”

Section: Holly and Batzdorfmentioning

confidence: 99%

“…This constellation of symptoms is similar to those described by Holly and Batzdorf. 13 Roser et al 34 suggested that hydromyelia is a congenital condition; in the setting of trauma, syringomyelia could develop. 10 Based on these studies, it is difficult to determine if slitlike syringes, hydromyelia, and IS are truly different entities or simply a continuum on a spectrum.…”

Section: Holly and Batzdorfmentioning

confidence: 99%

“…15,26,34 Although not clearly defined, the general consensus seems to be that IS is not associated with any of the conditions mentioned previously. 3,28,31,34,37 The management and natural history of such idiopathic syringes remain unclear. Here, we present our experience with IS in a retrospective case series of 8 patients, and we provide a comprehensive review of the current evidence.…”

mentioning

confidence: 92%

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Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management

Roy¹,

Slimack²,

Ganju³

2011

FOC

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Object A syrinx is a fluid-filled cavity within the spinal cord that can be an incidental finding or it can be accompanied by symptoms of pain and temperature insensitivity. Although it is most commonly associated with Chiari malformation Type I, the advancement of imaging techniques has resulted in more incidental idiopathic syringes that are not associated with Chiari, tumor, trauma, or postinfectious causes. The authors present a comprehensive review and management strategies for the idiopathic variant of syringomyelia. Methods The authors retrospectively identified 8 idiopathic cases of syringomyelia at their institution during the last 6 years. A PubMed/Medline literature review yielded an additional 38 articles. Results Two of the authors' patients underwent surgical treatment that included a combination of laminectomy, lysis of adhesions, duraplasty, and syrinx fenestration. The remaining 6 patients were treated conservatively and had neurologically stable outcomes. Review of the literature suggests that an etiology-driven approach is essential in the diagnosis and management of syringomyelia, although conservative management suffices for most cases. In particular, it is important to look at disturbances in CSF flow, as well as structural abnormalities including arachnoid webs, cysts, scars, and a diminutive posterior fossa. Conclusions The precise etiology for idiopathic syringomyelia (IS) is still unclear, although conceptual advances have been made toward the overall understanding of the pathophysiology of IS. Various theories include the cerebellar piston theory, intramedullary pulse pressure theory, and increased spinal subarachnoid pressure. For most patients with IS, conservative management works well. Continued progression of symptoms, however, could be approached using decompressive strategies such as laminectomy, lysis of adhesions, and craniocervical decompression, depending on the level of pathology. Management for patients with progressive neurological dysfunction and the lack of flow disturbance is unclear, although syringosubarachnoid shunting can be considered.

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Section: Holly and Batzdorfmentioning

confidence: 99%

Section: Holly and Batzdorfmentioning

confidence: 99%

Section: Holly and Batzdorfmentioning

confidence: 99%

mentioning

confidence: 92%

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Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management

Roy¹,

Slimack²,

Ganju³

2011

FOC

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“…Median clinical follow-up was 20.5 months, and median radiological follow-up was 13 months. The median maximum syrinx diameter was 2 mm (range 0.5-17 mm) and the median number of vertebral levels spanned was 5 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Eighty-one of the patients had a syrinx diameter equal to or greater than 2 mm.…”

Section: Resultsmentioning

confidence: 99%

Management of idiopathic pediatric syringohydromyelia

Rodriguez

Kuhn

Somasundaram

et al. 2015

PED

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OBJECT Syringohydromyelia is frequently identified on spinal imaging. The literature provides little guidance to decision making regarding the need for follow-up or treatment. The purpose of this study was to review the authors' experience in managing pediatric syringohydromyelia of unknown cause. METHODS A single-institution retrospective review of all cases involving pediatric patients who underwent spinal MRI from 2002 to 2012 was conducted. Patients with idiopathic syringohydromyelia (IS) were identified and categorized into 2 subgroups: uncomplicated idiopathic syrinx and IS associated with scoliosis. Clinical and radiological course were analyzed. RESULTS Ninety-eight patients (50 female, 48 male) met the inclusion criteria. Median age at diagnosis of syrinx was 11.9 years. Median maximum syrinx size was 2 mm (range 0.5–17 mm) and spanned 5 vertebral levels (range 1–20 vertebral levels). Thirty-seven patients had scoliosis. The most common presenting complaint was back pain (26%). Clinical follow-up was available for 78 patients (80%), with a median follow-up of 20.5 months (range 1–143 months). A neurological deficit existed at presentation in 36% of the patients; this was either stable or improved at last follow-up in 64% of cases. Radiological follow-up was available for 38 patients (39%), with a median duration of 13 months (range 2–83 months). There was no change in syrinx size in 76% of patients, while 16% had a decrease and 8% had an increase in syrinx size. Thirty-six patients had both clinical and radiological follow-up. There was concordance between clinical and radiological course in 14 patients (39%), with 11 patients (31%) showing no change and 3 patients (8%) showing clinical and radiological improvement. No patients had concurrent deterioration in clinical and radiological course. One patient with scoliosis and muscular dystrophy underwent direct surgical treatment of the syrinx and subsequently had a deteriorated clinical course and decreased syrinx size. CONCLUSIONS There remains a paucity of data regarding the management of pediatric IS. IS in association with scoliosis can complicate neurosurgical decision making. There was no concordance between radiological syrinx size increase and clinical deterioration in this cohort, indicating that surgical decision making should reflect clinical course as opposed to radiological course.

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Non-Hindbrain-Related Syringomyelia

Klekamp

2013

The Chiari Malformations

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Defining the line between hydromyelia and syringomyelia. A differentiation is possible based on electrophysiological and magnetic resonance imaging studies

Cited by 46 publications

References 26 publications

Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management

Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management

Management of idiopathic pediatric syringohydromyelia

Non-Hindbrain-Related Syringomyelia

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