Figure 143

Axial T2WI of the lumbar spine in a 20-year-old patient with persistent low back pain. Within the distal cord/conus a hyperintense rounded syrinx was found (arrow). The lesion did not enhance with contrast and no tumor was found.

Di Lorenzo N, Cacciola F: Adult syringomyelia: Classification , pathogenesis and therapeutic approaches. J Neurosurg Sci 49: 65-72, 2005.

Gamache FW, Ducker TB: Syringomyelia: A neurological and surgical spectrum. J Spinal Disord 3: 293-298, 1990.

Heiss JD, Patronas N, DeVroom HL, Shawker T, Ennis R, Krammerer W, Eidsath A, Talbot T, Morris J, Eskioglu E, Oldfield EH: Elucidating the pathophysiology of syringomyelia. J Neurosurg 91: 553-562, 1999.

Hida K, Iwasaki Y, Imamura H, Abe H: Posttraumatic syringomyelia: Its characteristic magnetic resonance imaging findings and surgical management. Neurosurgery 35: 886-891, 1994.

Jaksche H, Schaan M, Schulz J, Bosczcyk B: Posttraumatic syringomyelia: A serious complication in tetra- and paraplegia patients. Acta Neurochir Suppl 93: 165-167, 2005.

Klekamp J, Iaconetta G, Samii M: Spontaneous resolution of Chiari I malformation and syringomyelia: Case report and review of the literature. Neurosurgery 48: 664-667, 2001.

Lee BCP, Zimmerman RD, Manning JJ, Deck MD: MR imaging of syringomyelia and hydromy-elia. Am J Roentgenol 144: 1149-1156, 1985.

Lee J-H, Chung C-K, Kim HJ: Decompression of the spinal subarachnoid space as a solution for syringomyelia without Chiari malformation. Spinal Cord 40: 501-506, 2002.

Lyons BM, Brown DJ, Calvert JM: The diagnosis and management of post-traumatic syringomyelia. Paraplegia 25: 340-350, 1987.

Medlock MD: Syringomyelia. Semin Spine Surg 12: 141-150, 2000.

Milhorat TH, Capocelli AL, Anzil AP, Kotzen RM, Mihorat RH: Pathological basis of spinal cord cavitation in syringomyelia. Analysis of 105 autopsy cases. J Neurosurg 85: 802-812, 1995.

Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C: Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 44: 1005-1017, 1999.

Milhorat TH, Johnson RW, Milhorat RH, Capocelli AL Jr, Pevsner PH: Clinicopathological correlations in syringomyelia using axial magnetic resonance imaging. Neurosurgery 37: 206-213, 1995.

Rossier AB, Foo D, Shillito J, Dyro FM: Posttraumatic cervical syringomyelia. Incidence, clinical presentation, electrophysiological studies, syrinx protein and results of conservative and operative treatment. Brain 108: 439-461, 1985.

Squier MV, Lher RP: Post traumatic syringomyelia. J Neurol Neurosurg Psychiatry 57: 10951098, 1994.

Takigami I, Miyamoto K, Kodama H, Hosoe H, Tanimoto S, Shimizu K: Foramen magnum decompression for the treatment of Arnold Chiari malformation type I with associated syringomyelia in an elderly patient. Spinal Cord 43: 249-251, 2005.

Uhlenbrock D, Henkes H, Weber W, Felber S, Kuehne D: Non-dysraphic malformations, pp. 133-141 in Uhlenbroch D: MR imaging of the spine and spinal cord. Georg Thieme Verlag, 2004.

Chronic adhesive arachnoiditis (CAA) is a progressive inflammatory disorder that starts with radiculitis and gradually evolves to intrathecal scarring and granulation that encapsulate the nerve roots and lead to clumping of nerve roots to each other or to the dura. CAA tends to develop following multiple spinal surgeries, spinal infection, spinal trauma, intraspinal hemorrhage, intrathecal steroid administration, or oil-based myelograms. Up to 16% of failed back surgery patients develop CAA.

The condition affects both genders equally and typically evolves over weeks to months following the precipitating events. Initially, an inflammatory process develops in the pia-arachnoid with nerve root swelling and hyperaemia. Subsequently, collagen is deposited and the nerve roots adhere to each other and later on are completely encapsulated with dense collagen tissue. The scar tissue interferes with the neural blood supply, resulting in neural atrophy. It may also cause disturbances of cerebrospinal fluid flow, which may lead to interstitial edema and increased pressure within the cord and, eventually, syrin-gomyelia. In late stages of the disease calcification or ossification surrounding the arachnoid may occur.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

Get My Free Ebook


Post a comment