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Syringomyelia Case Study

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Introduction: Syringomyelia arising from the expansion of the central canal located in the center of the medulla spinalis are rarely seen formations. The incidence is higher soon after Arnold Chiari Malformation and past spinal trauma. It may occur after the spinal cord is under the influence of external compression, when there are cord-related tumoral formations and after the cerebral spinal fluid, (CSF) dynamics in the central canal are disturbed. Although different theories have been described in its pathogenesis, a precise definition has yet to be made which can explain the development mechanism of isolated syringomyelia. Materials and Methods: In the medical history of 11 out of 91 patients diagnosed with syringomyelia, there was past spinal trauma history, whereas in 11 patients Arnold Chiari Malformation was detected. A total of 69 patients were followed-up with isolated syringomyelia diagnosis; it was seen that internal and external pathological findings …show more content…

Most frequently, syringomyelia was detected in the cervical region ( xx,x % ). The most common symptoms were pain and dysesthesia complaint in the neck and extremities, sensory lost was the most frequently encountered findings in the neurological examination (xx,x%). Motor findings were detected in xx patients. Xx patients were incidentally diagnosed with syringomyelia. Time of onset of symptoms is x,x years on average, the time from the onset of symptoms to diagnosis was calculated as x,x months/year. It was noted that the deficits were not bilaterally identical in xx patients, and there was segmental asymmetry in sensory and motor findings. In clinical follow-ups, patients had periods of regression and progression in symptoms. In radiological follow-ups, it was observed that the syrinx cavity did not always tend to grow, there were periods in which it regressed and progressed regarding segments and

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Cranial nerves continue intact, including the extraocular eye movements being intact without nystagmus. Visual fields are full in both eyes. He had no papilledema or atrophy of either optic disc. Pupils react from 4 down to 2 mm, bilaterally brisk and round to light and accommodation. He continues to have good strength with normal bulk and tone throughout his extremities.

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Range of motion is limited with flexion and extension of 20 degrees limited by pain. Spurling test is positive. Sensation is diminished C5-C6 bilaterally. Diagnoses are cervical strain, bilateral C5-C6 cervical radiculopathy, and diminished sensation, C6 reflex bilaterally.

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IW complains of increased pain and swelling in her neck, supraclavicular, clavicular and trapezius areas bilaterally, worse on the right. IW states her muscles are tight and tense. IW continues with choking on saliva at times, increased from her normal. IW complains of increased radicular neck pain with pain radiating between her shoulder blades, arms and fingers. IW notes she gets a purplish hue to her hands after driving and when her neck pain increases.

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Symptoms are non-specific and characteristically include a history of headaches from intracranial hypertension secondary to obstruction of cerebral spinal fluid (CSF) in the ventricles. In addition, vomiting, nausea, visual disturbances, such as Parinaud Syndrome, auditory and balance deficits may be present as a result of pyramidal tract dysfunction. The proximity of the tectal plate to the aqueduct of Sylvius in the mesencephalon makes non-communicating hydroencephalus the most likely culprit for the increased intracranial pressure.

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