scholarly journals The “presyrinx” state: is there a reversible myelopathic condition that may precede syringomyelia?

2000 ◽  
Vol 8 (3) ◽  
pp. 1-13 ◽  
Author(s):  
Nancy J. Fischbein ◽  
William P. Dillon ◽  
Charles Cobbs ◽  
Philip R. Weinstein
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Clinical Evidence ◽  
Cervical Spinal Cord ◽  
Central Canal ◽  
Intramedullary Tumor ◽  
Csf Flow ◽  
Before And After ◽  
Late Evolution ◽  
History Of

Object Alteration of cerebrospinal fluid (CSF) flow has been proposed as an important mechanism leading to the development of syringomyelia. We hypothesize that a “presyrinx” condition due to potentially reversible alteration in normal CSF flow exists and that its appearance may be due to variations in the competence of the central canal of the spinal cord. Methods Five patients with clinical evidence of myelopathy, no history of spinal cord trauma, enlargement of the cervical spinal cord with T1 and T2 prolongation but no cavitation, evidence for altered or obstructed CSF flow, and no evidence of intramedullary tumor or a spinal vascular event underwent MR imaging before and after intervention that alleviated obstruction to CSF flow. Results Preoperatively, all patients demonstrated enlarged spinal cords and parenchymal T1 and T2 prolongation without cavitation. Results of magnetic resonance (MR) imaging examinations following intervention in all patients showed resolution of cord enlargement and normalization or improvement of cord signal abnormalities. In one patient with severe arachnoid adhesions who initially improved following decompression, late evolution into syringomyelia occurred in association with continued CSF obstruction. Conclusion Nontraumatic obstruction of the CSF pathways in the spine may result in spinal cord parenchymal T2 prolongation that is reversible following restoration of patency of CSF pathways. We refer to this MR appearance as the “presyrinx” state and stress the importance of timely intervention to limit progression to syringomyelia.

Successful neuroendoscopic third ventriculostomy for hydrocephalus and syringomyelia associated with fourth ventricle outlet obstruction

2000 ◽  
Vol 93 (2) ◽  
pp. 326-329 ◽  
Author(s):  
Takaichi Suehiro ◽  
Takanori Inamura ◽  
Yoshihiro Natori ◽  
Masayuki Sasaki ◽  
Masashi Fukui
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Fourth Ventricle ◽  
Cervical Spinal Cord ◽  
Outlet Obstruction ◽  
Central Canal ◽  
Third Ventriculostomy ◽  
Content Type ◽  
Cine Mr ◽  
Downward Displacement

✓ The authors report the use of neuroendoscopic third ventriculostomy to treat successfully both hydrocephalus and syringomyelia associated with fourth ventricle outlet obstruction. A 27-year-old woman presented with dizziness, headache, and nausea. Magnetic resonance (MR) imaging demonstrated dilation of all ventricles, downward displacement of the third ventricular floor, obliteration of the retrocerebellar cerebrospinal fluid (CSF) space, funnellike enlargement of the entrance of the central canal in the fourth ventricle, and syringomyelia involving mainly the cervical spinal cord. Cine-MR imaging indicated patency of the aqueduct and an absent CSF flow signal in the area of the cisterna magna, which indicated obstruction of the outlets of the fourth ventricle. Although results of radioisotope cisternography indicated failure of CSF absorption, neuroendoscopic third ventriculostomy completely resolved all symptoms as well as the ventricular and spinal cord abnormalities evident on MR images. Neuroendoscopic third ventriculostomy is an important option for treating hydrocephalus in patients with fourth ventricle outlet obstruction.

Intraoperative MR imaging in a case of a cervical spinal cord lesion

2011 ◽  
Vol 14 (6) ◽  
pp. 754-757 ◽  
Author(s):  
David Netuka ◽  
Svatopluk Ostrý ◽  
Tomáš Belšán ◽  
Filip Kramář ◽  
Vladimír Beneš
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Cavernous Malformation ◽  
Cervical Spinal Cord ◽  
Spinal Cord Lesion ◽  
Cervical Cord ◽  
Cervical Pain ◽  
Neck Flexion ◽  
Before And After ◽  
Cord Lesion

The aim of this article is to describe the feasibility of performing intraoperative MR imaging in patients with spinal cord lesions and the potential value of this technique. The authors report a case involving a 28-year-old man who presented with chronic cervical pain and pain along the ulnar side of the forearms during neck flexion. Findings on clinical examination were normal, but MR imaging revealed a multicystic cervical spinal cord lesion. Surgery was undertaken to open the cysts, evacuate old blood, and search for pathological tissue. Intraoperative MR imaging showed that the caudal cyst was not opened, and surgery was therefore continued. The caudal cyst was fenestrated and a suspected small cavernous malformation was removed. Electrophysiological monitoring was performed both before and after the intraoperative MR imaging. The use of intraoperative MR imaging changed the strategy of the procedure and helped the surgeon to safely enter all the cysts in the cervical cord.

scholarly journals Standard and cardiac-gated phase-contrast magnetic resonance imaging in the clinical course of patients with Chiari malformation Type I

2011 ◽  
Vol 31 (3) ◽  
pp. E5 ◽  
Author(s):  
Uwe Max Mauer ◽  
Andreas Gottschalk ◽  
Carolin Mueller ◽  
Linda Weselek ◽  
Ulrich Kunz ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Chiari Malformation ◽  
Phase Contrast ◽  
Foramen Magnum ◽  
Central Canal ◽  
Type I ◽  
Csf Flow ◽  
Chiari Malformation Type I ◽  
Cerebrospinal Fluid Flow ◽  
Contrast Magnetic Resonance

Object The causal treatment of Chiari malformation Type I (CM-I) consists of removing the obstruction of CSF flow at the level of the foramen magnum. Cerebrospinal fluid flow can be visualized using dynamic phase-contrast MR imaging. Because there is only a paucity of studies evaluating CSF dynamics in the region of the spinal canal on the basis of preoperative and postoperative measurements, the authors investigated the clinical usefulness of cardiacgated phase-contrast MR imaging in patients with CM-I. Methods Ninety patients with CM-I underwent preoperative MR imaging of CSF pulsation. Syringomyelia was present in 59 patients and absent in 31 patients. Phase-contrast MR imaging of the entire CNS was used to investigate 22 patients with CM-I before surgery and after a mean postoperative period of 12 months (median 12 months, range 3–33 months). In addition to the dynamic studies, absolute flow velocities, the extension of the syrinx, and tonsillar descent were also measured. Results The changes in pulsation were highly significant in the region of the (enlarged) cistern (p = 0.0005). Maximum and minimum velocities (the pulsation amplitude) increased considerably in the region where the syrinx was largest in diameter. The changes of pulsation in these patients were significant in the subarachnoid space in all spinal segments but not in the syrinx itself and in the central canal. Conclusions The demonstration of CSF flow pulsation can contribute to assessments of surgical outcomes. The results presented here, however, raise doubts about current theories on the pathogenesis of syringomyelia.

Subpial schwannoma of the cervical spinal cord mimicking an intramedullary tumor

2006 ◽  
Vol 24 (10) ◽  
pp. 690-694 ◽  
Author(s):  
Nozomi Ozawa ◽  
Takahiko Tashiro ◽  
Terue Okamura ◽  
Koichi Koyama ◽  
Kenji Ohata ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Intramedullary Tumor

scholarly journals Lacrosse Equipment and Cervical Spinal Cord Space During Immobilization: Preliminary Analysis

2010 ◽  
Vol 45 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Michael Higgins ◽  
Ryan T. Tierney ◽  
Jeffrey B. Driban ◽  
Steven Edell ◽  
Randall Watkins
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Repeated Measures ◽  
Cervical Spinal Cord ◽  
Spine Injury ◽  
Imaging Center ◽  
Mri Scans ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Cervical Spine Alignment

Abstract Context: Removal of the lacrosse helmet to achieve airway access has been discouraged based only on research in which cervical alignment was examined. No researchers have examined the effect of lacrosse equipment on the cervical space available for the spinal cord (SAC). Objective: To determine the effect of lacrosse equipment on the cervical SAC and cervical-thoracic angle (CTA) in the immobilized athlete. Design: Observational study. Setting: Outpatient imaging center. Patients or Other Participants: Ten volunteer lacrosse athletes (age  =  20.7 ± 1.87 years, height  =  180.3 ± 8.3 cm, mass  =  91 ± 12.8 kg) with no history of cervical spine injury or disease and no contraindications to magnetic resonance imaging (MRI). Intervention(s): The lacrosse players were positioned supine on a spine board for all test conditions. An MRI scan was completed for each condition. Main Outcome Measure(s): The independent variables were condition (no equipment, shoulder pads only [SP], and full gear that included helmet and shoulder pads [FG]), and cervical spine level (C3–C7). The dependent variables were the SAC and CTA. The MRI scans were evaluated midsagittally. The average of 3 measures was used as the criterion variable. The SAC data were analyzed using a 3 × 5 analysis of variance (ANOVA) with repeated measures. The CTA data were analyzed with a 1-way repeated-measures ANOVA. Results: We found no equipment × level interaction effect (F3.7,72  =  1.34, P  =  .279) or equipment main effect (F2,18  =  1.20, P  =  .325) for the SAC (no equipment  =  5.04 ± 1.44 mm, SP  =  4.69 ± 1.36 mm, FG  =  4.62 ± 1.38 mm). The CTA was greater (ie, more extension; critical P  =  .0167) during the SP (32.64° ± 3.9°) condition than during the no-equipment (25.34° ± 2.3°; t9  =  7.67, P  =  .001) or FG (26.81° ± 5.1°; t9  =  4.80, P  =  .001) condition. Conclusions: Immobilizing healthy lacrosse athletes with shoulder pads and no helmets affected cervical spine alignment but did not affect SAC. Further research is needed to determine and identify appropriate care of the lacrosse athlete with a spine injury.

Evaluation of the central canal of the spinal cord in experimentally induced hydrocephalus

1978 ◽  
Vol 48 (6) ◽  
pp. 970-974 ◽  
Author(s):  
A. Everette James ◽  
William J. Flor ◽  
Gary R. Novak ◽  
Ernst-Peter Strecker ◽  
Barry Burns
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Experimental Model ◽  
Alternative Pathway ◽  
Central Canal ◽  
Communicating Hydrocephalus ◽  
Csf Flow ◽  
Content Type ◽  
Histological Appearance ◽  
Fine Print

✓ The central canal of the spinal cord has been proposed as a significant compensatory alternative pathway of cerebrospinal fluid (CSF) flow in hydrocephalus. Ten dogs were made hydrocephalic by a relatively atraumatic experimental model that simulates the human circumstance of chronic communicating hydrocephalus. The central canal was studied by histopathology and compared with 10 normal control dogs. In both groups the central canal of the spinal cord was normal in size, configuration, and histological appearance. In this experimental model dilatation of the canal and increased movement of CSF does not appear to be a compensatory alternative pathway.

Cervical spinal cord in experimental hydrocephalus

1972 ◽  
Vol 37 (5) ◽  
pp. 538-542 ◽  
Author(s):  
George J. Dohrmann
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Cervical Spinal Cord ◽  
Central Canal ◽  
Content Type ◽  
Experimental Hydrocephalus ◽  
Physiological Pressure ◽  
The Brain ◽  
Shunting Procedure ◽  
Fine Print

✓ Adult dogs were rendered hydrocephalic by the injection of kaolin into the cisterna magna. One group of dogs was sacrificed 1 month after kaolin administration, and ventriculojugular shunts were performed on the other group. Hydrocephalic dogs with shunts were sacrificed 1 day or 1 week after the shunting procedure. All dogs were perfused with formalin at physiological pressure, and the brain stem and cervical spinal cord were examined by light microscopy. Subarachnoid granulomata encompassed the superior cervical spinal cord and dependent surface of the brain stem. Rarefaction of the posterior white columns and clefts or cavities involving the gray matter posterior to the central canal and/or posterior white columns were present in the spinal cords of both hydrocephalic and shunted hydrocephalic dogs. Predominantly in the dogs with shunts, hemorrhages were noted in the spinal cord in association with the clefts or cavities. A mechanism of ischemia followed by reflow of blood is postulated to explain the hemorrhages in the spinal cords of hydrocephalic dogs with shunts.

Aggressive surgery for intramedullary tumor of cervical spinal cord

1996 ◽  
Vol 46 (4) ◽  
pp. 322-328 ◽  
Author(s):  
Qi-Wu Xu ◽  
Wei-Min Bao ◽  
Ren-Ling Mao ◽  
Guo-Yuan Yang
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Intramedullary Tumor
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