Syringomyelia: Current Concepts in Pathogenesis, Diagnosis, and Treatment

Abstract

Syringomyelia is a condition that results in fluid-containing cavities within the parenchyma of the spinal cord as a consequence of altered cerebrospinal fluid dynamics. This review discusses the history and the classification of the disorder, the current theories of pathogenesis, and the advanced imaging modalities used in the diagnosis. The intramedullary pulse pressure theory (a new pathophysiologic concept of syringomyelia) also is presented. In addition, the current understanding of the painful nature of this condition is discussed and the current trends in medical and surgical management are reviewed.

Syringomyelia in a Newborn Male Simmental Calf

“…The distinction between syringomyelia and hydromyelia is arbitrary; hydromyelia might extend into the spinal cord and form syringohydromyelia partially lined by ependyma9 and cavities might communicate with the central canal 10. At present, the term syringomyelia is generally accepted for all spinal cord cavitations containing cerebrospinal or similar fluids 8. A maldeveloped cerebellum with elongated cerebellar tonsils through the foramen magnum (Arnold‐Chiari malformation) is seen in human infants and calves of many breeds 11.…”

Low‐Field Magnetic Resonance Imaging and Multislice Computed Tomography for the Detection of Cervical Syringomyelia in Dogs

“…However, any dilatation of the central canal should be considered abnormal. Hence, the detection of smaller dilatations on both MR and CT is important as progressive central canal dilatation is a precursor of syrinx formation 1, 34. Furthermore, results of a previous study suggest that SW progresses with time in CKCS 34.…”

“…Syringomyelia (SM) is a condition characterized by the development of fluid‐containing cavities in the spinal cord 1. The fluid in the cavities resembles cerebrospinal fluid but has a lower protein content 2, 3.…”

“…Syringomyelia has been considered as a rare disease in veterinary medicine, but is more and more recognized in animals because of the increased availability of magnetic resonance imaging (MRI) and the increased prevalence in certain breeds such as Cavalier King Charles spaniels (CKCS),4 Griffon Bruxellois5, and other small or ‘toy’ breeds 6. One of the most common causes in dogs is Chiari‐like malformation in CKCS 1, 7, 8. In this disorder there is a mismatch between the caudal cranial fossa volume and brain parenchyma which leads to cerebellar herniation, medullary kinking, obstruction of the dorsal craniocervical subarachnoid space, and alteration of the cerebrospinal fluid flow 7.…”

“…Magnetic resonance imaging is mentioned in several articles in human and veterinary medicine as the preferred imaging technique for visualizing changes in the spinal cord and to detect SM 1, 13, 14, 15, 16. However, plain computed tomography (CT) and CT after intrathecal injection of nonionic contrast media have also been used in human medicine to detect SM 16.…”