Post-traumatic syringomyelia with holocord involvement: a case report

Amin, Idris; Ilizarov, Gavriil A.; Chowdhury, Nayeema; Kalva, Shailaja

doi:10.1038/scsandc.2017.54

Cited by 4 publications

(5 citation statements)

References 8 publications

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“…[9,16] Holocordsyringomyelia can occur in patients with a history of SCI and present with new onset focal neurologic deficit. [17] In patients with incidental syringomyelia without any other predisposing condition, close observation is recommended rather than surgery. MRI is the imaging modality of choice and syrinx characteristically follows CSF signal characteristics on all sequences, that is hypointense on T1WI, hyperintense on T2WI.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Syrinx and Its Associations: A Retrospective Study

Prasad¹,

Harsha²,

Raj³

2019

AJMRR

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Background: Syrinxis described as a cavitary enlargement of the spinal cord. It is a common reason for neurosurgical referral. The aetiology of syrinx is multiple andit is associated with other brain and spinal cord conditions,while some are not associated with any other conditions. Subjects and Methods: We retrospectively collected data of cases diagnosed with syrinx in the department of radiodiagnosis in Rajarajeswari Medical college, Bangalore and studied the conditions associated with syrinx. Results: A total of 37 cases were analysed. The spinal cord levelsmost commonly associated with syrinx were C5, C6, T1 and L1 vertebral levels. Arnold Chiari malformation type 1 was the most common condition associated with syrinx. Conclusion: It was concluded from the present study that syrinx was more common in males than females with mean age of presentation of 36 years. The cervical spinal cord level was most commonly involved followed by thoracic and lumbar spinal cords. ACM type 1 was the most common associated condition. It becomes important for radiologist to look for syrinx in cases diagnosed with associated conditions, so that subtle and mild forms of syrinx are not missed and their growth or expansion in spinal cord be evaluated in follow up MRI studies.

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Section: Discussionmentioning

confidence: 99%

Analysis of Syrinx and Its Associations: A Retrospective Study

Prasad¹,

Harsha²,

Raj³

2019

AJMRR

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“…Syrinx, including the entire spinal cord, has been reported in chiari malformations; however, cases reported in posttraumatic SCI patients are extremely rare. Approximately 10 cases of posttraumatic syringomyelia with holocord involvement have been reported in the literature 1,2,5,7,8) . Generally, symptoms of syringomyelia occur 1 to 34 years after their initial SCI.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, symptoms of syringomyelia occur 1 to 34 years after their initial SCI. Unlike common posttraumatic syringomyelia, patients with posttraumatic holocord syringomyelia were diagnosed 19 to 34 years after the primary injury 1,2) . Awai and Curt 2) described cases of posttraumatic holocord syrinx where 4 patients were diagnosed with posttraumatic holocord syringomyelia.…”

Section: Discussionmentioning

confidence: 99%

“…However, the study was not specifically confined to the holocord syrinx and shunt operations were performed in all 3 cases of holocord syrinx patients. Some other studies 1,5) described a patient with posttraumatic holocord syringomyelia treated with a syringosubarachnoid shunt. In those studies, the postoperative course during acute inpatient rehabilitation was unremarkable, but the long term effects are unknown due to follow-up loss.…”

Section: Discussionmentioning

confidence: 99%

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Posttraumatic Syringomyelia with Holocord Involvement: A Case Report

Lee

Lyo

Kwon

et al. 2018

Nerve

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Posttraumatic syringomyelia occurs in nearly half of all spinal cord injury (SCI) patients. However, there haves been very few cases of syringomyelia of the entire spinal cord, known as holocord syringomyelia. Here, we discuss a case of posttraumatic holocord syringomyelia in the light of the literature review. A 43-year-old man presented with ongoing motor weakness of the left upper extremity. He had a history of SCI with a spinal fusion operation 5 years ago. Magnetic resonance imaging (MRI) of the spine revealed an expansive high signal intensity lesion in the spinal cord from the medulla to T12. Total T8 laminectomy and syringopleural shunt placement were performed. The patient's motor weakness of the left upper extremity recovered and the extent of syrinx decreased remarkably at the 1 year follow up MRI. Physicians should consider holocord syringomyelia as a possibility in patients with ongoing neurologic deficit with a history of SCI.

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“…Based on the etiology, syringomyelia divided into traumatic and non-traumatic syringomyelia. 1 The most common cause is Chiari Malformation type 1 which contributes more than 50% as non-traumatic cause of syringomyelia. In recent years, there are several publication that presents various surgical technique for syringomyelia related Chiari Malformation type 1, in other hand management for syringomyelia related trauma is still lack of literature and debatable [1] [2].…”

Section: Introductionmentioning

confidence: 99%

Surgical Procedure And Future Treatment Options For Posttraumatic Syringomyelia : A Systematic Review

Ananda

Iskandar²,

Hamzah³

2022

AANHS-J

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Objectives To find the most effective surgical procedure for posttraumatic syringomyelia (PTS) in the last 1 decade. And to look for the latest therapeutic strategies that have the opportunity to be developed in the future. Background Syringomyelia related trauma is uncommon case compared to other etiology such as Chiari Malformation type 1. The management of PTS is remain unclear and debatable. The aim of this study is to review PTS regarding surgical procedure, outcomes, and potential future treatment strategies. Methods This study uses a structured analyses focused on preferred reporting items for systematic review and meta-analyzes (PRISMA). Document selection using the keywords “Postraumatic Syringomyelia” AND “Syringomyelia” and based on publication (10 years). We selected based on the 2020 PRISMA checklist and based on inclusion and exclusion criteria. A total 17 studies met the eligibility criteria. We recorded treatment strategies, level of syrinx, severity of injury, injury to symptom duration and outcomes. Results A total 264 participants with PTS from 15 observational studies and 2 clinical trials were reviewed. We recorded 68% of participants were treated surgically (n=181). The most common procedure is arachnoid lysis and duraplasty (32,5%, n= 59) followed by syrinx shunting (15,4%, n=28) and subarachnoid-subarachnoid bypass (11%, n=20). We found that the syrinx shunting was the most successful procedure with symptoms improved in 82% of patients postoperatively. Overall, symptoms improved in 60% participants who underwent surgery (n=110). We also found deterioration from surgical procedure in 18% participants (n=32). Beside of surgical strategy we also found another therapeutic option that use mesenchymal stromal cells (MSCs) that injected into the syrinx. We recorded a 100% success rate from this procedure (n=7) Conclusion Although the overall outcomes of the surgical procedure for PTS are still unsatisfactory, the syrinx shunting procedure seems to be considered as the most effective surgical procedure. Other therapeutic strategies such as MSCs is considered promising but still require further researches with larger sample sizes. Keywords : syringomyelia, syrinx shunting, trauma

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Post-traumatic syringomyelia with holocord involvement: a case report

Abstract: The patient was able to make significant recovery and was successfully discharged home. There are a limited number of reports published about post-traumatic holocord syringomyelia. It is important to recognize this diagnosis during follow-up visits with spinal cord injury patients.

Cited by 4 publications

References 8 publications

Analysis of Syrinx and Its Associations: A Retrospective Study

Analysis of Syrinx and Its Associations: A Retrospective Study

Posttraumatic Syringomyelia with Holocord Involvement: A Case Report

Surgical Procedure And Future Treatment Options For Posttraumatic Syringomyelia : A Systematic Review

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