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Arrested hydrocephalus and the presyrinx state. Case report
Natarajan Muthukumar1, Govindaraju Venkatesh, Subbiah Thiruppathy
1Department of Neurosurgery, Madurai Medical College, India. prasan86@eth.net
Journal of Neurosurgery
|November 24, 2005
Summary
Arrested hydrocephalus can lead to the presyrinx state, a condition causing walking difficulties. Prompt treatment with a shunt can resolve this rare association and improve myelopathic symptoms.
Area of Science:
- Neurology
- Pediatric Neurosurgery
Background:
- Hydrocephalus and syringomyelia share known associations.
- The presyrinx state, a precursor to syringomyelia, is a recently identified condition.
- The link between arrested hydrocephalus and the presyrinx state is exceptionally rare.
Observation:
- A 6-year-old girl with arrested hydrocephalus presented with new-onset gait disturbance.
- Clinical examination revealed macrocrania and cervical myelopathy.
- Magnetic resonance imaging demonstrated panventriculomegaly and the presyrinx state in the cervical spine.
Findings:
- The patient received a ventriculoperitoneal shunt for medium-pressure cerebrospinal fluid diversion.
- Myelopathic symptoms improved significantly within 6 months post-surgery.
- Follow-up imaging confirmed ventricular decompression and complete resolution of the presyrinx state.
Implications:
- This case suggests the presyrinx state can manifest as a complication of decompensated arrested hydrocephalus.
- Early diagnosis and intervention are crucial for managing this rare condition.
- Understanding this association offers insights into the pathogenesis of syringomyelia.