Syrinx Of The Spinal Cord Or Brain Stem

A syrinx is a liquid-filled cavity within the spinal cord (syringomyelia) or the brainstem (Syringobulbia). Predisposing factors are abnormalities of the craniocervical junction, previous spinal cord trauma and Rückenmarktsumoren. Symptoms include a flaccid paralysis of the hands and arms and deficits in the perception of pain and temperature with a cape-like distribution pattern on the back and neck; the perception of light touch and the position and vibration sense are not affected. The diagnosis is made by an MRI. Treatment includes a correction of the cause and surgical procedures to drain the syrinx or otherwise to make the CSF flow freely.

(See also overview of diseases of the spinal cord.)

A syrinx is a liquid-filled cavity within the spinal cord (syringomyelia) or the brainstem (Syringobulbia). Predisposing factors are abnormalities of the craniocervical junction, previous spinal cord trauma and Rückenmarktsumoren. Symptoms include a flaccid paralysis of the hands and arms and deficits in the perception of pain and temperature with a cape-like distribution pattern on the back and neck; the perception of light touch and the position and vibration sense are not affected. The diagnosis is made by an MRI. Treatment includes a correction of the cause and surgical procedures to drain the syrinx or otherwise to make the CSF flow freely. (See also overview of diseases of the spinal cord.) A syrinx is usually caused by lesions that partially block the CSF flow. At least half of Syrinxbildungen occur in patients with congenital abnormalities of the craniocervical junction (z. B. entrapment of cerebellar tissue into the spinal canal, so-called. Chiari malformation), brain (z. B. encephalocele) or spinal cord (z. B. myelomeningocele) ago. For unknown reasons, these congenital anomalies often expand in adolescence or young adulthood. A syrinx may form in patients with spinal cord tumors, scarring due to Spinaltraumas had taken place or with no known predisposing factors also. About 30% of people with a spinal cord tumor develop a syrinx ultimately. Syringomyelia is a paramedian, mostly irregular longitudinally aligned cavity. It usually begins in the cervical area, but it may extend distally along the entire length of the spinal cord. In the syringobulbia, which is rare, there is usually a slit-like gap in the lower brain stem, which can interrupt or compress the lower cranial nerve nuclei, the ascending sensitive or descending motor pathways. Symptoms and signs The symptoms of Syrinx usually begins insidiously between adolescence and age 45. Syringomyelia develops in the center of the spinal cord, thus causing a central cord syndrome (see table: Spinal Cord Syndrome). Deficits in pain and temperature perception occur early, but are often for years not recognized. The first abnormality which is noticed may be painless or a combustion section. Typically, syringomyelia weakness, atrophy and often fasciculation and reflex attenuation caused in the hands and arms. A deficit in the perception of pain and temperature with a cape-like distribution pattern on shoulders, arms and back is characteristic. The perception of light touch and the position and vibration sense are not affected. Later, a spastic paralysis of the legs developed. Deficits may be distributed asymmetrically. A Syringobulbia may cause dizziness, nystagmus, single or double-sided loss of sensation in the face, atrophy and weakness of the tongue, dysarthria, dysphagia, hoarseness, and sometimes peripheral sensory or motor deficits cause by a medullary compression. Diagnostics MRI of the spinal cord and brain with gadolinium For Syrinx speak an unexplained central spinal cord syndrome or other characteristic neurological deficits, particularly pain and temperature sense interference with a cape similar distribution pattern. An MRI of the entire spinal cord and the brain is performed. Gadoliniumhaltiges contrast agent is useful for the discovery of a possibly associated tumor. Cervicothoracic syringohydromyelia Courtesy of John Tsiouris, M.D., Division of Neuroradiology, New York-Presbyterian Hospital / Weill Cornell Medical Center. var model = {thumbnailUrl: ‘/-/media/manual/professional/images/syrinx_slide_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/syrinx_slide_high_de.jpg?la = en & thn = 0 ‘, title:’ cervicothoracic syringohydromyelia ‘description:’ u003Ca id = “v37896664 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDas sagittal T1-weighted MRI after administration of contrast agent shows a large T1 hypo intense intramedullary cavity in the spinal cord of a syrinx (yellow arrow). It extends from the cervical C2-C3-level inferiorly in a child with a known Chiari Malformation I (red arrow). This finding represents a syringohydromyelia because in imaging syringomyelia (an eccentric cavity in the spinal cord) from a hydromyelia (a central cavity in the spinal cord) can not be distinguished. U003c / p u003e u003c / div u003e ‘credits : ‘. courtesy of John Tsiouris

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